Benns Matthew, Dalsing Michael, Sawchuck Alan, Wurtz L Daniel
Indiana University School of Medicine, Indianapolis, USA.
J Vasc Surg. 2006 Apr;43(4):788-93. doi: 10.1016/j.jvs.2005.12.039.
To bring attention to our observation that soft tissue sarcomas may present initially as deep venous thromboses (DVTs).
A query of our health system database (1996 to 2004) for patients diagnosed with soft tissue sarcomas and DVTs was undertaken. Patient medical records were reviewed to select those patients whose DVT occurred before the diagnosis of their tumor. Patient demographics, tumor classification, presentation, and outcome were noted.
Six of 19 patients were identified (four men, two women; aged 41 to 85 years). All tumors occurred in the lower extremities. All DVTs occurred in the same extremity as the tumor. Pathology specimens indicated four different types of sarcomas. In five cases, sarcoma diagnosis was delayed as treatment of the DVT occurred. In one, a mass was seen on the initial venous duplex screen. Four are deceased, one remains in treatment, and one was lost to follow-up. The average length of follow-up was 10 months.
Soft tissue sarcomas can initially present as, or even be misdiagnosed as, DVT. Given a delay in diagnosis adversely affects prognosis, it is important that physicians be vigilante for associated tumors when evaluating for suspected DVT.
引起人们对我们所观察到的软组织肉瘤最初可能表现为深静脉血栓形成（DVT）这一现象的关注。
对我们的医疗系统数据库（1996年至2004年）进行查询，以找出被诊断患有软组织肉瘤和DVT的患者。查阅患者的病历，以挑选出那些DVT发生在肿瘤诊断之前的患者。记录患者的人口统计学信息、肿瘤分类、临床表现和治疗结果。
在19名患者中识别出6例（4名男性，2名女性；年龄41至85岁）。所有肿瘤均发生在下肢。所有DVT均发生在与肿瘤相同的肢体。病理标本显示为四种不同类型的肉瘤。在5例中，由于对DVT进行了治疗，肉瘤诊断被延迟。在1例中，最初的静脉双功超声检查发现了一个肿块。4例已死亡，1例仍在接受治疗，1例失访。平均随访时间为10个月。
软组织肉瘤最初可能表现为DVT，甚至可能被误诊为DVT。鉴于诊断延迟会对预后产生不利影响，医生在评估疑似DVT时对相关肿瘤保持警惕很重要。
