Thrumurthy Sri G, Anuruddha Abeyratne H M P, De Zoysa Merrenna I M, Samarasekera Dharmabandhu N
University Surgical Unit, National Hospital of Sri Lanka, Colombo 10, Sri Lanka.
BMC Surg. 2011 Jan 6;11:1. doi: 10.1186/1471-2482-11-1.
Unprovoked superficial thrombophlebitis and subsequent venous thromboembolism are well-described albeit rare presenting features of advanced visceral malignancy that often manifest too late for curative intervention to be beneficial.
We present the first reported case of early gastric carcinoma presenting with these paraneoplastic phenomena in an otherwise healthy farmer. The early presentation allowed for a curative partial gastrectomy, which itself was complicated by the presence of a deep vein thrombosis extending into the inferior vena cava. Fortunately, stabilization of the clot allowed for surgery to proceed without the need for a caval filter. The patient was referred for adjuvant chemotherapy and has since made an excellent recovery.
This case provides new evidence for the presentation of superficial thrombophlebitis in early gastric carcinoma and the potential for curative surgery in such instances. A high index of suspicion and a prompt diagnostic workup are essential for timely planning and execution of surgery in these early albeit rare presentations.
无诱因的浅表性血栓性静脉炎及随后的静脉血栓栓塞是晚期内脏恶性肿瘤的典型表现，尽管较为罕见，且往往出现得太晚，以至于进行根治性干预已无益处。
我们报告了首例以这些副肿瘤现象为表现的早期胃癌病例，患者是一位原本健康的农民。早期表现使得能够进行根治性部分胃切除术，而手术本身因存在延伸至下腔静脉的深静脉血栓形成而变得复杂。幸运的是，血栓稳定使得手术得以继续进行，无需放置腔静脉滤器。患者被转诊接受辅助化疗，此后恢复良好。
该病例为早期胃癌出现浅表性血栓性静脉炎及此类情况下进行根治性手术的可能性提供了新的证据。对于这些早期虽罕见但仍需及时进行手术规划和实施的病例，高度的怀疑指数和迅速的诊断检查至关重要。
