Subclavian vein thrombosis: an unusual presentation of renal cell carcinoma

Abstract

Subclavian vein thrombosis is an uncommon clinical condition which is often associated with venous catheterization or secondary to excessive effort. We present a 54-year-old female with subclavian vein thrombosis as a first presentation of renal cell carcinoma. Although this is an unusual presentation, malignancy should be considered in the differential diagnosis. Hypercoagulability as part of a paraneoplastic syndrome was considered a possible etiology. In patients with otherwise unexplained subclavian vein thrombosis, full systemic examination and radiological evaluation of the abdomen, retroperitoneum and pelvis should be pursued. A review of the literature relevant to this unusual case is provided.

Clinical Spectrum of Patients with Renal Cell Carcinoma

“…It is due to tumor thrombus extending along the renal vein that blocks drainage of left spermatic vein into inferior vena cava (IVC).It is not just left spermatic vein that may become clogged .Right spermatic vein is at risk too. Shinsaka et al reported a case of right varicocele as a result of RCC thrombus in right spermatic vein without simultaneous caval thrombosis (Al-Taan et al, 2007;Shinsaka et al, 2006).Furthermore, prothrombotic state as a paraneoplastic feature of RCC may cause thrombosis in unusual sites such as subclavian veins (Hameed et al,2011). Hence, it is worthwhile to consider RCC in evaluating patients with idiopathic venous thrombosis, especially in an unusual site.…”