Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 4 3 2019 12 17 e79 e79 Pedram Keshavarz Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Sara Haseli Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Neda Akhondzadeh Department of Emergency Medicine, Poursina Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran 2019 08 19 2019 11 08 Introduction: Superior vena cava (SVC) syndrome which is defined as the obstruction of blood flow through the SVC vein, often affecting patients with malignancy especially small cell lung cancer (SCLC) and is potentially an emergent condition needing prompt management. It is an ominous sign with poor prognosis and a mean of 8-10 months survival rate.  Case presentation: Here we present a middle-aged man who presented with fascial swelling and dyspnea with final diagnosis of advanced SCLC. Combination of multiple chemotherapy regimen, prophylactic brain radiation with administration of anticoagulant drugs were performed for him leading toward extension of his survival to 28 months.  Conclusion: These therapeutic approaches may lead to extending the survival in patients with SVC syndrome and SCLC. https://fem.tums.ac.ir/index.php/fem/article/view/250 https://fem.tums.ac.ir/index.php/fem/article/download/250/253