Case 169


JJS, a 42-year-old male patient, developed 2 months ago a right-sided chest pain, with progressive worsening and radiating to right shoulder and neck associated with dry cough and dyspnoea. Evolved with cervicofacial oedema, exacerbated by the supine position. Refers weight loss of 7 kg over the past two months and episodes of chills and fever of 38°C. On clinical examination, there were cervicofacial and upper limbs oedema, more intense in left side. Presence of telangiectasia and collateral circulation in mammary, supraclavicular and infraclavicular regions.


Based on the clinical picture and the images, which one of the following is the most likely diagnosis?

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