Pemberton's sign

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Pemberton's sign is the development of facial plethora, distended neck and head superficial veins, inspiratory stridor and elevation of the jugular venous pressure (JVP) upon raising of the patient's both arms above his/her head simultaneously (Pemberton's maneuver).

A positive Pemberton's sign is a sign of superior vena cava syndrome, possibly from a mass in the mediastinum, usually caused by a tumour or struma. It is also associated with a thyroid goiter large enough to cause compressive symptoms.

Apical lung cancers often cause a positive Pemberton's sign and a high index of suspicion should be maintained in patients with symptoms of dyspnoea and facial plethora with an extensive smoking history.

One of the less known causes of a Positive Pemberton's sign is the presence of a retrosternal extension of a goitre.