Symptoms – Swelling of the Face and Neck

Lung cancer can cause swelling in the face and neck when a tumor (malignancy) presses on the vein that goes from the head to the heart. This symptom is called superior vena cava syndrome or superior vena cava obstruction. The superior vena cava is the name of the vein that carries blood from the head and arms to the heart. The superior vena cava passes near the upper part of the right lung, as well as near lymph nodes in the chest cavity. Tumors in or around the lung or in the lymph nodes may interfere with the functioning of the superior vena cava, blocking the normal flow of blood.1,2

Superior vena cava obstruction is most often caused by cancer. In addition to lung cancer, other cancers that may cause superior vena cava obstruction include breast cancer, lymphoma, testicular cancer, thyroid cancer, and a thymus tumor. Superior vena cava obstruction can also be caused by other, noncancerous conditions, such as lung infections like tuberculosis, inflammation of a vein (thrombophlebitis), a fungal infection like histoplasmosis, an aortic aneurysm (bulging of a major artery that carries blood from the heart to the body), blood clots in the superior vena cava, enlargement of the thyroid gland, constrictive pericarditis (inflammation of the membrane surrounding the heart), or as a side effect of radiation therapy to the chest cavity.2

Symptoms of Superior Vena Cava Obstruction

The symptoms of superior vena cava obstruction may develop quickly or gradually. Early symptoms include swelling around the eye or in the face, particularly in the morning. Common symptoms of superior vena cava obstruction include shortness of breath and swelling of the face, neck, arms, or torso. Occasionally, superior vena cava obstruction can also cause symptoms of dizziness, headache, visual disturbances, fainting, and redness of the face, palms, or mucus membranes (tissue that produces mucus that lines many inner parts of the body) in the nose or mouth. Superior vena cava obstruction is serious and may be life threatening. It requires immediate medical attention.1,2

Assessing Superior Vena Cava Obstruction

A physician may notice swelling of the face, neck, and upper chest in a physical examination. Additional imaging techniques used to diagnose superior vena cava obstruction include:

  • Bronchoscopy, a thin tube placed into the windpipe to view the lungs
  • Chest x-ray
  • CT (computed tomography) scan
  • MRI (magnetic resonance imaging)
  • Coronary angiography, which looks at the heart blood vessels
  • Ultrasound of the blood vessels
  • Radionuclide ventriculography, which studies the motion of the heart and surrounding vessels (may also be called multiple-gated acquisition or MUGA scan)2

Treating Superior Vena Cava Obstruction

Treatment of superior vena cava obstruction aims to relieve the blockage. In the case of lung cancer, tumors will be targeted using chemotherapy, radiation therapy, surgery, and/or targeted therapies. Medications such as diuretics or steroids may be used to temporarily reduce the swelling. In some cases, a stent (tiny tube placed in the vessel to keep it open) is placed in the superior vena cava.2

Other Symptoms of Lung Cancer

In addition to swelling of the face and neck, other symptoms of lung cancer include:

Written by: Emily Downward | Last reviewed: January 2017.
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