INFILTRATIVE MEDIASTINO-HILOPULMONARY TUMOR CAUSING CARDIAC TAMPONADE AND SVC SYNDROME: A DRAMATIC PRESENTATION

Mediastinal tumors pose significant diagnostic and therapeutic challenges due to their heterogeneous nature and often insidious progression. We report the case of a 52-year-old male professional varnisher with chronic exposure to isocyanates and a history of heavy smoking, who rapidly developed acute cardiac tamponade and superior vena cava (SVC) syndrome secondary to an extensively infiltrative mediastino-hilopulmonary tumor. Clinical presentation included severe respiratory distress, hemodynamic instability, and a tumor syndrome characterized by bilateral cervical masses and an epigastric mass suggestive of metastatic spread. Imaging revealed a large mediastinal mass invading vital thoracic structures, accompanied by massive pericardial effusion and vascular thrombosis. Echocardiography confirmed tamponade physiology with hallmark features consistent with current guidelines. Critical hemodynamic instability precluded invasive histological diagnosis, and despite intensive supportive measures, the patient died shortly after admission. This case highlights the diagnostic delays and therapeutic limitations in managing advanced mediastinal malignancies complicated by life threatening cardiopulmonary sequelae.