Abstract
INTRODUCTION: Superior vena cava (SVC) syndrome is a well-recognized complication of thoracic malignancies, most commonly small-cell lung cancer. Endovascular stenting is preferred because it provides rapid symptom relief and restores venous patency. However, the role of post-stenting anticoagulation remains controversial, and complications related to its use are rarely reported. We describe such a case in a patient with malignant SVC syndrome. CASE PRESENTATION: A 51-year-old woman with small-cell carcinoma of the lung and SVC syndrome underwent stenting of the SVC. After the procedure, she was on prophylactic low-molecular-weight heparin and developed a large retroperitoneal hematoma with a significant decrease in hemoglobin on day four. The patient was managed with a transfusion and conservative care. Massive retroperitoneal hematomas secondary to anticoagulation therapy after SVC stenting are highly uncommon. CONCLUSION: There is currently no consensus guideline on post-stenting anticoagulation in malignant SVC syndrome. This case highlights one of the problems encountered in the post-stenting scenario of malignant SVC syndrome.