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This case highlights the importance of considering T-ALL in the differential diagnosis of SVCS, particularly in younger individuals without traditional risk factors. Early recognition and prompt initiation of appropriate therapy, including chemotherapy and potentially radiation therapy, are crucial for optimal patient outcomes. This case underscores the need for a high index of suspicion for rare malignancies, even in the context of common presentations.<\/jats:p>","DOI":"10.1136\/bcr-2024-264162","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T17:45:55Z","timestamp":1739814355000},"page":"e264162","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Primary mediastinal T-ALL presenting with superior vena cava syndrome"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2293-8190","authenticated-orcid":false,"given":"Alison","family":"Gibbons","sequence":"first","affiliation":[{"name":"Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Tito","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Baik","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ines","family":"Kafando","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"2025082712490089000_18.2.e264162.1","unstructured":"Seligson M , Surowiec S . 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