Superior Vena Cava Syndrome (SVCS) may be mistaken for angioedema. Usually a routine screening chest x-ray will demonstrate the presence of a mediastinal mass, thus, establishing the diagnosis of SVCS. In those cases where the chest x-ray is initially interpreted as normal, an alert physician can differentiate the diagnosis of SVCS by pathognomonic signs of progressive telangiectasia of the chest wall together with plethora and facial edema, and distended, prominent jugular veins. Progressive telangiectasia ("venous stars") is a most important diagnostic sign. A prompt tissue diagnosis and immediate treatment are mandatory. A case report of SVCS initially manifesting as angioedema is presented.
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