Iliofemoral Venous Thrombosis Mainly Related to Iliofemoral Venous Obstruction by External Tumor Compression in Cancer Patients

Liao, Tzu-Yao; Hsu, Hui‐Ching; Wen, Min-Sheng; Juan, Yu-Hsiang; Hung, Yu-Hsin; Liaw, Chuang-Chi

doi:10.1159/000452943

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…Moreover, whereas PE was not discovered in bladder cancer or stomach cancer cases, DVT was found in 13.9% and 4.4% of the patients, respectively [18]. VTE is common in ovarian cancer due to vascular dehydration caused by ascites [19] and venous compression by a large tumor [20]. In clear cell carcinoma, Factor VII is activated via the extrinsic blood coagulation pathway, leading to the production of tissue factors that augment coagulation [21,22], and this is thought to be one of the causes for high VTE rates.…”

Section: Discussionmentioning

confidence: 98%

Malignant Tumor Is the Greatest Risk Factor for Pulmonary Embolism in Hospitalized Patients: A Single-Center Study

Fujieda

Nozue

Watanabe

et al. 2020

Preprint

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BackgroundThis study aimed to investigate the background of patients who presented with pulmonary embolism (PE) on contrast-enhanced chest computed tomography (CT) and to explore the risk factors for PE.MethodsThis study included a review of the medical records of all 50,621 patients who were admitted to one community hospital between January 1, 2013 and December 31, 2017. Data on sex, age, risk factors related to blood flow stagnation (obesity, long-term bed rest, cardiopulmonary disease, cast fixation, long-term sitting), risk factors related to vascular endothelial disorder (surgery, trauma/fracture, central venous catheterization, catheter tests/treatments, vasculitis, antiphospholipid antibody syndrome, history of venous thromboembolism (VTE)), and risk factors related to hypercoagulability (malignant tumor, use of oral contraceptives/low-dose estrogen progestin/steroids, infection, inflammatory enteric disease, polycythemia, protein C or protein S deficiency, dehydration) were evaluated.ResultsOf all inpatients, 185 (0.37%) were diagnosed with PE after contrast-enhanced chest CT examination. The rate of discovering PE was significantly greater in women (0.48%, 93/19,409) than men (0.29%, 92/31,212) (P=0.0008). Of the 185 patients with PE, 173 (94%) had some type of risk factor. For both men and women, the most frequent risk factor was a malignant tumor, followed by infection and obesity for men and long-term bed rest and obesity for women. The most common malignant tumor was lung cancer. Of the 12 patients whose clear PE-inducing factor could not be identified, but there is possible involvement of antipsychotic agent.ConclusionsThe risk factors for PE were identified in this single-center, retrospective study.

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Section: Discussionmentioning

confidence: 98%

Malignant Tumor Is the Greatest Risk Factor for Pulmonary Embolism in Hospitalized Patients: A Single-Center Study

Fujieda

Nozue

Watanabe

et al. 2020

Preprint

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“…Deep vein thrombosis secondary to external compression by tumors has been reported in other settings such as the superior vena cava, and pulmonary and iliofemoral veins. [40][41][42] It has been reported once in the setting of NF1, by an exostosis, in the popliteal vein. 10 One study 43 conducted with patients harboring high-grade non-Hodgkin lymphoma showed that venous compression by the tumor was present in 51% of patients with DVT.…”

Section: Discussionmentioning

confidence: 99%

Deep Vein Thrombosis in the Setting of Neurofibromatosis Type 1: Case Report

Guedes

Torrão

Sanches

et al. 2021

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Background Neurofibromatosis type 1 (NF1) is a genetic syndrome which typically presents with neurological manifestations. Some of the patients may also present with vasculopathies, among which arterial aneurysms and stenosis are the most common. Deep vein thrombosis (DVT) has rarely been described, and, to the best of our knowledge, the present is the first report of DVT due to venous compression by a neurofibroma in the setting of NF1. Case presentation This is the case of a 23-year-old male with NF1 who experienced DVT due to compression of the left posterior tibial veins by a large tumor arising from the tibial nerve. The DVT was acutely treated with enoxaparin and then with rivaroxaban. Two months after the diagnosis, Doppler ultrasonography showed partial recanalization and persistence of the DVT. The patient was then referred to neurosurgery for surgical resection of the tumor. There were no complications during the procedure, and the patient did not present postoperative neurological deficits. The final histopathological diagnosis was of a benign neurofibroma. After one year of follow-up with vascular surgery, the patient presented no more episodes of DVT. Conclusion In case there is a tumor compressing the deep vessels of the leg and promoting DVT, surgical resection with microsurgical techniques may be curative.

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“…Most of the reported cases of Iliofemoral venous compression with resultant DVT have been due to compression by enlarged lymph nodes secondary to Urothelial or gynecological malignancies. Liao et al, 9 analyzed 893 cancer patients over a 10 year period.…”

Section: Discussionmentioning

confidence: 99%

A ureteral mass presenting as deep vein thrombosis: a very rare presentation

Sharma¹,

Sharma²,

Gehlawat³

2018

UNOAJ

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Case presentation A 45 year old post-menopausal female presented to her primary physician with complaints of left foot swelling which gradually progressed to involve the entire left lower limb. She did not give any antecedent history of trauma, ulceration on lower limb, haematuria, lower urinary tract symptoms, bowel complaints, vaginal bleeding, loss of weight, loss of appetite, previous history of DVT. There was no history of previous surgeries and co-existing morbidities. Her left lower limb was reddish in color, tense and tender to touch. Pervaginal examination revealed induration with in the left fornix. Rest of the general and systemic examination, were within normal limits. A venous Doppler revealed a partial thrombus of the Left Proximal external iliac vein and Left Common Iliac vein. Thrombophillic screen (PT-INR, aPTT, Protein C, Protein S, D, and Factor V Leiden Mutation) was within normal limits. Patient was started on Warfarin and put on total bed rest. Due to absence of any predisposing factors, further evaluation was considered and an ultrasound of the abdomen was done. It revealed a grossly dilated left renal pelvis with thinned out parenchyma & a 1.3*1.1cm lesion near the left vesicoureteric junction. Contrast-Enhanced CT of Abdomen & Pelvis Figure 1 was done which shows poorly functioning left kidney with gross hydronephrosis & thinned out parenchyma, large 6.6*4.5cm heterogeneously enhancing solid cystic mass in the left ureter at the level of the iliac vessel crossing and 3.5*2.1cm heterogeneously enhancing solid cystic lesion in left distal ureter extending up to VUJ. Her hemoglobin, serum creatinine, liver function tests, urinalysis were within normal limits. Urine for malignant cytology was negative. Cystoscopy showed a bulge just lateral to the left ureteric orifice and no other visible mass. The left ureteric orifice could not be cannulated. Considering the diagnosis of a ureteric mass, a Left Nephrouretectomy with bladder cuff excision was planned. Warfarin was stopped 5 days before surgery and patient was put on bridging therapy with low molecular weight heparin. A cardiology consult was taken and it was decided to insert an IVC filter 24 hours before surgery as prophylaxis to decrease risk of intra-operative and postoperative pulmonary embolism. Intra-operatively DVT pump was not applied. A Radical Nephroureterectomy along with Hysterectomy and Left Salpingo-oophorectomy (Figure 2) (Figure 3) was done with gynecological assistance in view of local invasion of cervix. Mid ureteric mass was dissected off the iliac vessels with CTVS assistance and final specimen consisted of the Left kidney, ureter, Uterus, Left Ovary along with Lymph Node dissection. Total intra-operative blood loss was 600ml. Post-operatively patient was kept in the ICU before shifting to the ward. Warfarin was restarted on day 3. Patient had a relatively uneventful post-operative period.

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Iliofemoral Venous Thrombosis Mainly Related to Iliofemoral Venous Obstruction by External Tumor Compression in Cancer Patients

Cited by 8 publications

References 25 publications

Malignant Tumor Is the Greatest Risk Factor for Pulmonary Embolism in Hospitalized Patients: A Single-Center Study

Malignant Tumor Is the Greatest Risk Factor for Pulmonary Embolism in Hospitalized Patients: A Single-Center Study

Deep Vein Thrombosis in the Setting of Neurofibromatosis Type 1: Case Report

A ureteral mass presenting as deep vein thrombosis: a very rare presentation

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