Deep vein thrombosis during chemotherapy in a patient with advanced testicular cancer: successful percutaneous thrombectomy under temporary placement of retrievable inferior vena cava filter.
A 27-year-old man with advanced testicular cancer experienced two events of deep vein thrombosis (DVT) during three cycles of cisplatin-based combination chemotherapy; the first thrombotic event occurred in the inferior vena cava (IVC) following the initial two cycles of chemotherapy and the second thrombotic event occurred in the right iliac vein following the third cycle. For both thrombotic events, he was successfully managed with thrombolytic therapy and percutaneous thrombectomy using a transcatheter hydraulic thrombectomy device under temporary placement of a retrievable IVC filter. Stasis of the IVC due to compression by a retroperitoneal lymphadenopathy of 7 cm in diameter, which was demonstrated on computed tomographic scans at presentation, was considered a major cause of DVT during chemotherapy. Patients with bulky retroperitoneal disease causing stasis of major veins are at high risk of DVT associated with chemotherapy and thromboprophylaxis should be strongly considered during their chemotherapy.
Department of Urology, Tokyo Rosai Hospital, Tokyo, Japan. f-koga@wine.plala.or.jp
F
F
Koga
T
T
Yamada
H
H
Ishimaru
S I
SI
Sadaoka
T
T
Mizuo
D000328:Adult; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D012074:Remission Induction; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017131:Thrombectomy / Q000379:methods*; D013997:Time Factors; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000139:chemically induced* / Q000628:therapy*