What associated finding is a contraindication to surgical resection in a patient with squamous cell carcinoma of the lung?

In the context of squamous cell carcinoma of the lung, the presence of superior vena cava obstruction is significant because it indicates advanced disease, often with extensive tumor burden and possible invasion of surrounding structures. This condition arises when the tumor compresses or invades the superior vena cava, leading to impaired venous return from the head, neck, and upper extremities back to the heart.

Surgical resection typically requires that the patient is operable, meaning that they can undergo surgery without significant risk and that the cancer is localized enough to be removed completely. When superior vena cava obstruction is present, it raises concerns about the extent of the carcinoma and may suggest that the disease is not suitable for surgical intervention. This condition often signals a more advanced stage of cancer that could potentially make the risks of surgery outweigh the benefits.

In contrast, the other findings listed, while they may be associated with squamous cell carcinoma, do not directly indicate an inoperable state. For example, finger clubbing, hypercalcaemia, and hypertrophic pulmonary osteoarthropathy can be paraneoplastic syndromes or associated conditions but do not inherently prevent surgical resection if the tumor itself is operable. Therefore, the presence of superior vena cava obstruction is a