Lin Wei-Ching, Lin Chien-Heng, Chao Yu-Hua, Lin Hsiao-Chuan, Chen Pei-Yu, Wu Han-Ping, Wu Kang-Hsi
*Departments of Radiology #Pediatrics **Pathology †School of Medicine ‡‡School of Chinese Medicine, China Medical University ‡Departments of Medical Imaging and Radiological Science §Children Education and Enterprise, Central Taiwan University of Science and Technology ∥Department of Pediatrics ¶School of Medicine, Chung Shan Medical University ††Department of Pediatrics, Buddhist Tzu-Chi General Hospital, Taichung Branch, Taichung, Taiwan.
J Pediatr Hematol Oncol. 2013 Nov;35(8):e320-2. doi: 10.1097/MPH.0b013e3182707a1a.
Thromboembolism presenting with malignancy is common in adults but rare in children. We describe the case of a 17-year-old boy admitted to our hospital with syncope. Computed tomography revealed thromboembolism in both the lungs. Magnetic resonance imaging found thromboembolism in the inferior vena cava and a large heterogeneous mass in the pelvis. Pelvic osteosarcoma was confirmed by computed tomography-guided biopsy. Despite intensive chemotherapy and local radiation, only transient response was noted, the tumor remaining unresectable. To our knowledge, this is the first reported case of simultaneous pulmonary and inferior vena cava thromboembolism secondary to pelvic osteosarcoma in children. We also emphasize syncope as a unique feature of pulmonary thromboembolism. Accordingly, thromboembolism should be kept in mind as the first manifestation of occult malignancy, even in children.
血栓栓塞合并恶性肿瘤在成人中很常见，但在儿童中很少见。我们描述了一名17岁男孩因晕厥入院的病例。计算机断层扫描显示双肺血栓栓塞。磁共振成像发现下腔静脉血栓栓塞和盆腔内一个大的异质性肿块。计算机断层扫描引导下的活检证实为盆腔骨肉瘤。尽管进行了强化化疗和局部放疗，但仅观察到短暂反应，肿瘤仍无法切除。据我们所知，这是首例儿童盆腔骨肉瘤继发同时性肺和下腔静脉血栓栓塞的报道病例。我们还强调晕厥是肺血栓栓塞的一个独特特征。因此，即使在儿童中，血栓栓塞也应被视为隐匿性恶性肿瘤的首发表现。
