A 66 year old Male Preeented to Er with complaints of Facial Swelling since 15 days, Cough  non productive with no diurnal Variation since 1 Month, Breathing difficulty since 1 Month  with no aggrevating or relieving factors. There was a History of change in Voice for past 3  months for which the patient didn’t neither took any treatment nor Evaluation.  There was no History of fever, chest pain, Palpitations, Syncope, Trauma, Decreased Urine  Output, Frothy Urine, Insect Bite or any history of similar complaints in the past.  Patient was then Evaluated for lower respiratory tract infections, Heart failure, Angioedema,  Nephrotic Syndrome.  After all the investigations Patient was diagnosed as superior vena cava syndrome caused  due to the Mediastinal Mass and Managed conservatively for superior vena cava Syndrome  and referred to Oncology Department for further care and Management.