# Palliative Radiotherapy and Corticosteroid Management for Tracheal Stenosis and Superior Vena Cava Syndrome Caused by a Large Mediastinal Mass Due to Adult T-cell Leukemia/Lymphoma: A Case Report

## TL;DR

A case report describes the successful use of palliative radiotherapy and corticosteroids to manage severe symptoms caused by a large mediastinal lymphoma in an elderly patient.

## Contribution

Presents a novel interim treatment strategy for SVC syndrome and airway stenosis when immediate hematology care is not available.

## Key findings

- Palliative radiotherapy combined with corticosteroids rapidly reduced the mediastinal mass.
- Symptoms like facial edema and dyspnea improved significantly following treatment.
- The approach provided stabilization in a patient with ATLL when hematology evaluation was delayed.

## Abstract

Superior vena cava (SVC) syndrome is a clinical condition caused by the compression or obstruction of the SVC, often due to malignant tumors in the mediastinum; it presents with facial edema, upper limb swelling, and dyspnea. We report the case of an 85-year-old man presenting with rapidly progressing SVC syndrome and airway stenosis due to a large mediastinal mass, later identified as malignant lymphoma. Urgent hematology evaluation proved to be difficult, and airway compromise posed immediate clinical challenges. Cytology and positive HTLV-1 serology suggested adult T-cell leukemia/lymphoma (ATLL). Due to rapid progression, palliative radiotherapy combined with corticosteroids was initiated promptly, resulting in a significant reduction of the mediastinal mass and rapid symptom improvement. This report highlights an effective interim strategy for stabilizing patients with massive mediastinal lymphoma presenting with SVC syndrome when immediate hematology referral is unavailable.