WHAT CAN HIDE BEHIND A DEEP VENOUS THROMBOSIS? CASE REPORT

  • Irina Iuliana COSTACHE “Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romani
  • Lucia GUSA “Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
  • V. FOTEA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • A.D. COSTACHE “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
  • B. HUZUM “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Viviana AURSULESEI “Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
  • A.O. PETRIS “Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
  • D. ILIESCU “Arcadia” Hospital Iasi, Romania
  • Delia HINGANU “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Abstract

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.

Author Biographies

Irina Iuliana COSTACHE, “Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romani

Department of Cardiology
“Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
Faculty of Medicine
Department of Medical Specialties (I)

V. FOTEA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Surgery (II)

A.D. COSTACHE, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania

Faculty of Medicine
Student

B. HUZUM, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Ph.D. Student

Viviana AURSULESEI, “Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania

Department of Cardiology
“Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
Faculty of Medicine
Department of Medical Specialties (I)

A.O. PETRIS, “Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania

Department of Cardiology
“Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
Faculty of Medicine
Department of Medical Specialties (I)

D. ILIESCU, “Arcadia” Hospital Iasi, Romania

Cardiology clinic

Delia HINGANU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Morpho-Functional Sciences (I)

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Published
2018-12-27
Section
INTERNAL MEDICINE - PEDIATRICS