A 68-year-old woman was admitted after suffering facial edema with neck vein engorgement ofr approximately 2 months. A chest X-ray showed a mild widening of the superior mediastinum and a luminal obliteration of the super ior vena cava (SVC) was noted on a computed tomograph. Venography showed that both subclavian veins were obstructed at the level of the poxima clavicle with a nonvisualization of the SVC. The SVC, both the innominate and the left inthrnal jugular veins were completely obstructed with extensive cord-like fibrotix changes despite the obsence of mediastinal involvement. The microscopic features showed a chronic granulomatous inflammation with a fibrosis minimally invading the mediastinal fat, which is cosistent with fibrosing mediastinitis.