Oliveira Nelson, Dias Emanuel, Lima Ricardo, Oliveira Fernando, Cássio Isabel
Department of Angiology and Vascular Surgery, Hospital do Divino Espírito Santo, 9500 Ponta Delgada, Portugal.
Case Rep Med. 2011;2011:123041. doi: 10.1155/2011/123041. Epub 2011 Jun 16.
Introduction. Primary venous tumours are a rare cause of deep vein thrombosis. The authors present a case where the definitive diagnosis was delayed by inconclusive complementary imaging. Clinical Case. A thirty-seven-year-old female presented with an iliofemoral venous thrombosis of the right lower limb. The patient had presented with an episode of femoral-popliteal vein thrombosis five months before and was currently under anticoagulation. Phlegmasia alba dolens installed progressively, as thrombus rapidly extended to the inferior vena cava despite systemic thrombolysis and anticoagulation. Diagnostic imaging failed to identify the underlying aetiology of the deep vein thrombosis. The definitive diagnosis of primary venous leiomyosarcoma was reached by a subcutaneous abdominal wall nodule biopsy. Conclusion. Primary venous leiomyosarcoma of the iliac vein is a rare cause of deep vein thrombosis, which must be considered in young patients with recurrent or refractory to treatment deep vein thrombosis.
引言。原发性静脉肿瘤是深静脉血栓形成的罕见原因。作者介绍了一例因补充影像学检查结果不明确而导致确诊延迟的病例。临床病例。一名37岁女性出现右下肢髂股静脉血栓形成。该患者5个月前曾发生过股腘静脉血栓形成，目前正在接受抗凝治疗。尽管进行了全身溶栓和抗凝治疗，但随着血栓迅速扩展至下腔静脉，白色疼痛性股肿逐渐加重。诊断性影像学检查未能确定深静脉血栓形成的潜在病因。通过腹壁皮下结节活检最终确诊为原发性静脉平滑肌肉瘤。结论。髂静脉原发性静脉平滑肌肉瘤是深静脉血栓形成的罕见原因，对于复发性或治疗难治性深静脉血栓形成的年轻患者必须考虑到这一病因。
