WHAT CAN HIDE BEHIND A DEEP VENOUS THROMBOSIS? CASE REPORT
Deep venous thrombosis is frequently associated with various malignancies and, in particular, with pulmonary ones and is two times more common in patients with malignancies than those without. Recognition or diagnosis of a DVT as a paraneoplastic syndrome is important because it could represent the early manifestations of an occult cancer, allowing diagnosis at an initial stage. We are reporting the case of a 62-year-old patient who was hospitalized in the Cardiology Clinic with clinical symptoms of deep venous thrombosis at the right lower limb. The diagnosis was confirmed by the imaging methods: venous echo doppler and phlebography. Catheter directed thrombolysis was performed, followed by conventional anticoagulant treatment with favorable response. The patient was also investigated etiologically but without a clear result. After one month, chest radiography revealed a suggestive image for lung cancer, which required thoracic CT and bronchoscopy with biopsy. These investigations confirmed the diagnosis of left pulmonary cancer with carinal invasion, of the scumamocellular type, with multiorganic secondary disseminations. The patient was directed to the Oncology Clinic. This case highlights the difficulty of making an etiologic diagnosis of deep venous thrombosis and a particular form of clinical onset of occult cancer. Since in the present case the occurrence of DVT preceded the diagnosis of the pulmonary cancer, the need to perform a screening of neoplasia is evident in case of any thromboembolic event occurring without an apparent cause, especially in the case of male patients.
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