Cancer Res Treat.  2010 Mar;42(1):48-52.

Diagnostic Laparoscopy of Patient with Deep Vein Thrombosis before Diagnosis of Ovarian Cancer: A Case Report

• Ha JE
• Lee YS
• Lee HN
• Park EK

Abstract

Venous thromboembolism (VTE) is a common complication in patients with malignant disease. Epidemiological studies have demonstrated an increased risk of subsequent cancer in the patients who are diagnosed with idiopathic venous thrombosis. Cancers of the breast, lung and ovary in women and adenocarcinomas of an unknown primary cancer are most strongly associated with thrombosis. Mucin-producing cancers are most often associated with VTE and the highest rates of VTE were found for cases of ovarian cancer, but the absolute risk of cancer after thrombosis is relatively low (about 2% over the first year) and so the benefit of screening for cancer in thrombosis patients seems limited. But as this case, the association between thrombosis and occult cancer shows the importance of this association for patients who have thrombosis that is unresponsive to anticoagulant therapy. Especially, we should recognize that such patients can undergo investigation for an underlying malignancy. Diagnostic laparoscopy of an adnexal mass for confirming cancer in the acute setting of deep vein thrombosis (DVT) was performed for our patient. We report here on a case of a patient with DVT in the upper and lower extremities before the diagnosis of ovarian cancer, and we briefly review of the relevant literature.

Keyword

Idiopathic thrombosis; Ovarian neoplasms; Laparoscopy

MeSH Terms

Adenocarcinoma
Breast
Female
Humans
Laparoscopy
Lower Extremity
Lung
Mass Screening
Ovarian Neoplasms
Ovary
Thrombosis
Venous Thromboembolism
Venous Thrombosis

Figure

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  Fig. 1 Left ascending leg venography revealed DVT involving the lower leg and the popliteal and femoral veins.

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  Fig. 2 Computed tomographic scan showing multiple myomas & several hypodense lesions in the pelvic cavity.

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  Fig. 3 Transvaginal ultrasonography showing a hyperechoic mass in the left adnexae.

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  Fig. 4 Transvaginal ultrasonography showing a hyperechoic mass in the left adnexae.

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  Fig. 5 Laparoscopy shows a small sized mucinous cystadenocarcinoma in the left ovary.

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  Fig. 6 The histologic presentation of moderate differentiated mucinous cystadenocarcinoma (H&E, ×200).

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