[Deep vein thrombosis caused by pelvic lymphocyst following radical prostatectomy: a case report].
A 66-year-old man was admitted with distal edema of his right leg. He had undergone radical prostatectomy and pelvic lymphadenectomy for prostatic cancer 23 days previously. Abdominal computed tomography (CT) showed a lymphocyst (4.5 x 3.0 cm) along the right pelvic wall compressing the right external iliac vein. CT with contrast medium showed thrombus formation (about 9 cm) in the distal portion of the right external iliac vein and femoral vein. An inferior vena cava filter was placed to prevent pulmonary embolism, and anticoagulation with warfarin was started. One week later, CT showed shrinkage of the lymphocyst and thrombus in the vein, as well as a large thrombus trapped in the filter. Follow-up CT taken 2 months later revealed marked reduction of the lymphocyst and absence of thrombus in both the vein and filter. A lymphocyst, also known as a lymphocele, is a complication of radical pelvic surgery. Most lymphocysts are asymptomatic and regress spontaneously, but may lead to deep vein thrombosis and pulmonary embolism, usually a few weeks after surgery. Careful observation is needed even after discharge from hospital.
Department of Cardiology, The Independent Administrative Institution, National Hospital Organization, Nagano. naoaki_hirabayashi@hospital.nagano.nagano.jp
Naoaki
N
Hirabayashi
Shumpei
S
Sakurai
Itsuki
I
Komiyama
Jin
J
Yokoyama
Kazuhiko
K
Kontani
Takehisa
T
Yoneyama
Yuichi
Y
Hirase
Hiroshi
H
Koshihara
Atsuko
A
Itoh
Uichi
U
Ikeda
D000368:Aged; D006801:Humans; D008210:Lymphocele / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D010388:Pelvis; D011183:Postoperative Complications; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery; D011655:Pulmonary Embolism / Q000517:prevention & control; D014057:Tomography, X-Ray Computed; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy