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Edison J. Cano, Damaris Pena, Misbahuddin Khaja
(Department of Internal Medicine, Bronx Lebanon Hospital Center, Bronx, NY, USA)
Med Sci Case Rep 2016; 3:104-107
Persistent left superior vena cava (PLSVC) is considered a benign incidental anatomical variant and is asymptomatic in the vast majority of cases.
CASE REPORT: This 35-year-old female presented with dysphagia, significant weight loss complicated by severe dehydration, and decreased renal function. Relevant past medical history included hypertension, chronic anemia, and multiple visits for dysphagia and non-cardiac chest pain. An initial upper gastrointestinal endoscopy showed no strictures, esophageal webs, or luminal esophageal lesions. While evaluating external esophageal compression, axial computed tomography with intravenous contrast showed PLSVC displacing mediastinal structures and tracheal deformity, explaining a previously found slight tracheal deviation on X-ray and coronary sinus dilation on echocardiography.
CONCLUSIONS: Herein we present a patient with a history of dysphagia and significant weight loss in whom all workup was negative, and extrinsic compression by a PLSVC deforming mediastinal anatomy was associated with the patient’s symptoms. To our knowledge, this is the first case reported of this rare association.