Shen Hongwei, Shang Jianhong, Niu Gang, Liu Jun, You Zeshan, He Shanyang
Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China.
Oncol Lett. 2015 Oct;10(4):2579-2583. doi: 10.3892/ol.2015.3497. Epub 2015 Jul 15.
Ovarian cancer associated with deep venous thrombosis (DVT) is an uncommon, potentially life-threatening condition. The primary therapeutic strategy for the treatment of this condition is up-front primary cytoreductive surgery, with placement of an inferior vena cava (IVC) filter prior to surgery to prevent fatal pulmonary embolism. The present study describes the case of a 49-year-old female, who presented with DVT unresponsive to anticoagulant therapy in the lower extremities prior to the diagnosis of ovarian cancer. During the search for the underlying malignancy, transvaginal sonography (TVS) revealed a cystic solid mass in the pelvic cavity. Subsequently, the patient underwent up-front primary cytoreductive surgery without placement of a preoperative IVC filter, followed by six cycles of chemotherapy. The patient was diagnosed with ovarian clear cell adenocarcinoma stage IIIC, complicated by DVT, and had survived >3 years without relapse at the time of completion of the present study. The successful outcome of the present case demonstrated that occult primary cancer should be suspected in patients with DVT unresponsive to anticoagulant therapy. The present study also indicated that up-front primary cytoreductive surgery without placement of an IVC filter represents an effective potential strategy for the treatment of advanced ovarian cancer associated with DVT, as the thrombus strongly adheres to the vessel wall following organization.
与深静脉血栓形成（DVT）相关的卵巢癌是一种罕见的、可能危及生命的疾病。治疗这种疾病的主要治疗策略是 upfront 原发性细胞减灭术，在手术前放置下腔静脉（IVC）滤器以预防致命的肺栓塞。本研究描述了一名 49 岁女性的病例，该女性在诊断卵巢癌之前出现下肢深静脉血栓形成，对抗凝治疗无反应。在寻找潜在恶性肿瘤的过程中，经阴道超声检查（TVS）发现盆腔内有一个囊实性肿块。随后，患者接受了 upfront 原发性细胞减灭术，未放置术前 IVC 滤器，随后进行了六个周期的化疗。患者被诊断为 IIIC 期卵巢透明细胞腺癌，并发深静脉血栓形成，在本研究完成时已存活超过 3 年且无复发。本病例的成功结果表明，对抗凝治疗无反应的深静脉血栓形成患者应怀疑隐匿性原发性癌症。本研究还表明，不放置 IVC 滤器的 upfront 原发性细胞减灭术是治疗与深静脉血栓形成相关的晚期卵巢癌的一种有效的潜在策略，因为血栓在机化后强烈粘附于血管壁。
