{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:06:23Z","timestamp":1790604383985,"version":"4.1.0"},"reference-count":8,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Superior vena cava syndrome is caused by obstruction of the superior vena cava leading to impaired drainage of the head, neck, and upper chest. A hot spot sign is a rare but sensitive radiological finding and is described as a focal area of hyper\u2010enhancement in Segment IVa (quadrate lobe) of the liver. It demonstrates an area of increased blood flow due to a collateral venous pathway in the setting of superior vena cava obstruction. We report a 60\u2010year\u2010old male presenting with facial and upper limb swelling, dyspnea, cough, weight loss, and prominent anterolateral chest wall veins. Laboratory tests were unremarkable. Contrast\u2010enhanced computed tomography (CT) revealed a right suprahilar mass infiltrating the SVC and azygos vein, with dense opacification of collateral pathways and a hyper\u2010enhancing wedge\u2010shaped area in Segment IVa of the liver, consistent with the \u201chot spot sign.\u201d Bronchoscopy and biopsy confirmed lung adenocarcinoma, positive for TTF\u20101 and negative for P40. The hepatic hot spot sign arises from portosystemic shunting via the superior vein of Sappey, which connects systemic veins\u2014including phrenic, internal thoracic, and superior epigastric veins\u2014to the left portal vein. Recognition of this pseudo\u2010lesion is critical, as it may mimic metastatic liver lesions and prevent unnecessary invasive procedures such as liver biopsy. Early identification of SVC obstruction facilitates prompt management and prevents complications. Contrast\u2010enhanced CT plays a pivotal role in detecting vascular liver changes secondary to SVC obstruction. Awareness of the hot quadrate sign is essential for early diagnosis and appropriate management of underlying malignancy.<\/jats:p>","DOI":"10.1002\/ccr3.73558","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:25:28Z","timestamp":1790601928000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Contrast\u2010Enhanced\n                    <scp>CT<\/scp>\n                    Finding of Hot Spot Sign Secondary to Supra Hilar Mass Causing Superior Vena Cava Syndrome: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"given":"Ghazala","family":"Shahzad","sequence":"first","affiliation":[{"name":"Liaquat University of Medical and Health Sciences  Jamshoro Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3115-9888","authenticated-orcid":false,"given":"Rabail","family":"Memon","sequence":"additional","affiliation":[{"name":"Liaquat University of Medical and Health Sciences  Jamshoro Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3664-151X","authenticated-orcid":false,"given":"Syed Muhammad Salman","family":"Hassan","sequence":"additional","affiliation":[{"name":"Nishtar Medical University  Multan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8811-1561","authenticated-orcid":false,"given":"Fatima","family":"Khan","sequence":"additional","affiliation":[{"name":"Islamabad Medical and Dental College  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remsha Hammeed","family":"Khan","sequence":"additional","affiliation":[{"name":"Liaquat University of Medical and Health Sciences  Jamshoro Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0717-2777","authenticated-orcid":false,"given":"Muddassir","family":"Khalid","sequence":"additional","affiliation":[{"name":"Nishtar Medical University  Multan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7441-9135","authenticated-orcid":false,"given":"Fred","family":"Segawa","sequence":"additional","affiliation":[{"name":"Makerere University College of Health Sciences  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"issue":"3","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/S1665-2681(19)31641-2","article-title":"The CT Quadrate Lobe Hot Spot Sign","volume":"9","author":"Virmani V.","year":"2010","journal-title":"Annals of Hepatology"},{"issue":"8","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1002\/rcr2.671","article-title":"The Focal Hepatic Hot Spot Sign With Lung Cancer in Computed Tomography","volume":"8","author":"Hoang V. T.","year":"2020","journal-title":"Respirology Case Reports"},{"key":"e_1_2_11_4_1","article-title":"Hot Quadrant Sign in a Lung Cancer Patient: A Rare Hepatic Pseudo\u2010Lesion Unveiling Superior Vena Cava Obstruction","author":"Zahoor M. M.","year":"2025","journal-title":"Cureus"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","DOI":"10.17235\/reed.2021.8154\/2021","article-title":"\u201cHot Quadrate Lobe Spot\u201d Sign in Chronic Superior Vena Cava Obstruction","author":"G\u00f3mez Varela C.","year":"2021","journal-title":"Revista Espa\u00f1ola de Enfermedades Digestivas"},{"issue":"24","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"2896","DOI":"10.1016\/j.jcin.2020.08.038","article-title":"Superior Vena Cava Syndrome","volume":"13","author":"Azizi A. H.","year":"2020","journal-title":"JACC. Cardiovascular Interventions"},{"issue":"3","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.2484\/rcr.v5i3.394","article-title":"Pseudolesion in Segment IV A of the Liver From Vein of Sappey Secondary to SVC Obstruction","volume":"5","author":"Vummidi D.","year":"2010","journal-title":"Radiology Case Reports"},{"issue":"46","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"7894","DOI":"10.3748\/wjg.v27.i46.7894","article-title":"Hepatic Pseudolesions Caused by Alterations in Intrahepatic Hemodynamics","volume":"27","author":"Kobayashi S.","year":"2021","journal-title":"World Journal of Gastroenterology"},{"key":"e_1_2_11_9_1","unstructured":"O.KhaderandM. A.Thabet \u201cThird Inflow to the Liver. Radiology Reference Article. Radiopaedia.org \u201d(2026) https:\/\/radiopaedia.org\/articles\/third\u2010inflow\u2010to\u2010the\u2010liver."}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73558","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73558","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73558","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:25:31Z","timestamp":1790601931000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":8,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/ccr3.73558"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73558","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"assertion":[{"value":"2026-03-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73558"}}