Hepatic Pseudolesion due to “Vein of Sappey” in Superior Vena Cava Syndrome

One of the common causes of superior vena cava (SVC) syndrome is malignancy of the lung. The invasion of SVC leads to opening of the various venous channels for continuation of the blood flow from upper extremity and proximal trunk and finally draining into right atrium. Vein of Sappey is one of these channels and it causes focal striking enhancement in segment IV of the liver on arterial phase of contrast computed tomography (CT). This enhancement causes diagnostic difficulty and unnecessary biopsy due to misinterpretation of it as a secondary from lung cancer. Awareness and accurate diagnosis can avoid further examination in such patients. It can also provide an idea of a more proximal major thoracic vessel obstruction if first detected on CT of the abdomen (contrast).