Venous Thromboembolism and Cancer

Piazza, Gregory

doi:10.1161/circulationaha.113.002702

Cited by 32 publications

(24 citation statements)

References 20 publications

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“…La frecuencia es mayor en tumores sólidos aunque malignidades hematológicas también contribuyen. A la clá-sica triada de Virchows: daño endotelial, ectasia y alteraciones de la coagulabilidad, en pacientes con cáncer hay que sumar otra triada recientemente propuesta: biología tumoral, activación de la coagulación y la inflamación (16). Aunque clásicamente se propone prevención con terapia anticoagulante (16), recientemente se ha puesto en duda el valor preventivo de la tromboprofilaxis en pacientes hospitalizados con cáncer (17).…”

Section: Discussionunclassified

Tumor de Krukenberg del ovario asociado a teratoma maduro

et al. 2015

Rev. chil. obstet. ginecol.

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RESUMENSe reporta un caso excepcional de tumor de Krukenberg ovárico bilateral asociado a teratoma maduro encontrado en una mujer de 54 años. La ecografía mostró al lado derecho tumor ovárico sólido de 55 mm y al lado izquierdo tumor quístico de 125 mm. Se realizó histerectomía total, salpingooforectomía bilateral, resección del epiplón mayor y muestras peritoneales. Al tercer día postcirugía, la paciente presentó signos de tromboembolismo pulmonar masivo y aunque recibió terapia anticoagulante falleció al quinto día postoperatorio. El estudio histológico mostró infiltración masiva de carcinoma de células en anillo positivas para citoqueratina en ambos ovarios. El ovario derecho mostró la forma sólida clásica del tumor de Krukenberg mientras que el ovario izquierdo correspondió a un quiste dermoide con infiltración tumoral de carcinoma de células en anillo en la pared.PALABRAS CLAVE: Tumor de Krukenberg, teratoma maduro, quiste dermoides, metástasis ováricas, metástasis tumor a tumor SUMMARYAn exceptional case of bilateral Krukenberg tumor of the ovary associated with mature teratoma presented in a 54 years old patient is reported. The ultrasound showed a 55 mm solid right ovarian tumor and a 125 mm left cystic ovarian tumor. Hysterectomy and bilateral salpingoophorectomy was performed including omental resection and peritoneal biopsies. Massive pulmonary embolism was detected in the third day after the surgery. Even anticoagulant therapy was established the patient died in the fifth postoperative day. The histological study revealed massive infiltration of signet ring cell carcinoma with positive expression for cytokeratin in both ovaries. The right ovary showed the classical solid form of the tumor. The left ovary was a dermoid cyst with signet ring cell carcinoma infiltrating the cystic wall.KEY WORDS: Krukenberg tumor, mature teratoma, dermoid cyst, ovarian metastases, tumor to tumor metastasis INTRODUCCIÓNEl ovario frecuentemente recibe metástasis de diversos carcinomas originados en órganos como estómago, colon, mama, apéndice cecal y vesícu-la biliar entre otros (1). La metástasis ovárica tiene rangos de incidencia variables con una media estimada de 10% de los tumores ováricos malignos y puede ser la primera manifestación de un carcinoma oculto localizado en un órgano distante (2,3).El tumor de Krukenberg, en sentido más restrictivo, representa una metástasis ovárica de carcinoma

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Section: Discussionunclassified

Tumor de Krukenberg del ovario asociado a teratoma maduro

et al. 2015

Rev. chil. obstet. ginecol.

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“…Patients with recently diagnosed oncological process are at higher risk of the metastatic disease [11] to the heart which is more common than primary cardiac neoplasia [34] and 15% of the patients with any type of cancer may present with cardiac metastases [10], which can occur through the direct invasion (lung or breast cancer), lymphatic (lymphomas or melanomas) and hematogenous (renal cell carcinoma) spread [10,11,34]. On the other hand, the hypercoagulable states, resulting in the venous thrombosis, the right heart and/or pulmonary thromboembolism, remain the significant causes of the morbidity and mortality for patients with cancer [12,13,23,24]. Furthermore, some publications maintain that the thrombosis or thromboembolism, especially when unprovoked, may declare a diagnosis of the cancer in a subset of patients without known malignancy and sometimes is called as the primary face of the cancer [25,26].…”

Section: Discussionmentioning

confidence: 99%

“…Although the exact pathogenetic mechanisms of the hypercoagulability in oncology remain obscure, there are obvious evidences that this type of patients have a wide variety of risk factors for the formation of the thrombus or migration of the embolus in the circulation through the right-side of the heart. The risk factors include the main oncological pathology with its pathogenic mechanisms that have a contagious cohesion with hipercoagulable states (the interaction of monocytes and macrophages with malignant cells, the production of the pro-coagulants or other substances as sialo acid from mucine in tumor cells), the applicable treatment (chemotherapy, surgery), a bed rest due to the critical condition or even the medical implements such as central venous catheters, commonly used in clinical practice, especially for patients with oncological process [13,24]. Alkindi et al presented the case of the catheter-related right atrial thrombosis in a patient with the history of cancer, treated by chemotherapy, and determined its related factors that could predispose the hypercoagulable state while using these medical implements [2].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown that patients with recently diagnosed oncological process are at higher risk of the metastatic heart disease [11] and 15 % of the patients with any type of cancer may present with cardiac metastases [10]. On the other hand, although the exact pathogenetic mechanisms of the hypercoagulability in oncology remain obscure, there are evidences that patients with a history of oncological process are at higher risk of the right-sided thromboembolism and its related complications [12][13][14]. In addition, masses inside the heart detected by echocardiography usually require further precise investigation in order to seperate the artefacts and innocent anatomic structures from the true cardiac masses.…”

Section: Introductionmentioning

confidence: 99%

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The Role of CMR Imaging for the Differential Diagnosis of Right-Sided Intracardiac Masses: A Case Report

et al. 2014

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SummaryMaterials and methods: intracardiac masses are described as abnormal structures inside the heart or immediately concerned to the heart [1] and can be classified as a cardiac tumor, metastasis, ,,thrombus in situ"/,,embolus in transit", vegetation or iatrogenic material [2,3]. The precise diagnosis is essential due to the necessity of the expedient well-timed treatment. We report a case of 58 year old woman with recently diagnosed left lung adenocarcinoma, admitted to the emergency department with pulmonary embolism. The case report presented here describes the findings of transthoracical echocardiography that suggested a right atrial mass -thrombus versus embolus. However, the subsequent CMR imaging helped to differentiate a true right atrial mass from a prominent crista terminalis. Conclusions: the cardiovascular magnetic resonance imaging is a valuable diagnostic method for the differentiation of the intracardiac masses when the transthoracical and/or transesophagial echocardiography is inadequate in some clinical cases. This noninvasive, cost-effective imaging technique has a larger field of view and differentiates various conditions of the heart therefore the expedient well-timed treatment could be applied.

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“…4 As early as 1868, Trousseau 5 described the relationship between malignancy and venous thrombosis. A large case-control study has shown that malignancy by itself increases the risk of VTEs by 7-to 10-fold; hematologic malignancies, including MM, are especially associated with high VTE risk (up to 28-fold), representing the highest reported risk of VTEs among patients with cancer.…”

Section: Thrombosis and MMmentioning

confidence: 99%