Oshinyemi Pamela, Lee Charlotte, Gough-Palmer Antony, McKay-Davies Iain
The Ear, Nose and Throat Department, Maidstone and Tunbridge Wells NHS Trust, Maidstone, Kent, UK
The Ear, Nose and Throat Department, Maidstone and Tunbridge Wells NHS Trust, Maidstone, Kent, UK.
BMJ Case Rep. 2021 Mar 17;14(3):e238813. doi: 10.1136/bcr-2020-238813.
A 43-year-old woman was referred to the Ear, Nose and Throat Department with a 3-day history of left-sided neck pain and swelling associated with fevers and night sweats. She also reported a cough, oral thrush and a dental extraction more than a month previously. A CT scan of the neck with contrast revealed left internal jugular vein (IJV) thrombophlebitis and the patient was initially managed for suspected Lemierre's syndrome. Subsequent investigations revealed a locally advanced metastatic colorectal adenocarcinoma as the cause of her thrombosis, which was deemed inoperable. The patient was referred to oncology and commenced on palliative chemotherapy.The incidence of thrombophlebitis in patients with cancer is high. Although the IJV is a relatively uncommon site of thrombus formation, IJV thrombophlebitis is associated with significant morbidity and mortality. As it may be the first manifestation of an occult malignancy, a neoplastic cause should always be considered.
一名43岁女性因左侧颈部疼痛和肿胀伴发热及盗汗3天被转诊至耳鼻喉科。她还报告了咳嗽、口腔念珠菌病以及一个多月前的一次拔牙。颈部增强CT扫描显示左颈内静脉血栓性静脉炎，患者最初因疑似勒米尔综合征接受治疗。随后的检查发现局部晚期转移性结直肠癌是其血栓形成的原因，该癌症被认为无法手术切除。患者被转诊至肿瘤科并开始接受姑息化疗。癌症患者血栓性静脉炎的发生率很高。虽然颈内静脉是血栓形成相对不常见的部位，但颈内静脉血栓性静脉炎与显著的发病率和死亡率相关。由于它可能是隐匿性恶性肿瘤的首发表现，因此应始终考虑肿瘤性病因。
