title: Successful diagnosis of thromboembolism before surgery in a woman with clear cell adenocarcinoma of the endometrium.
abstract: Patients with ovarian cancer with clear cell histology often have venous thromboembolism (VTE) even before surgery. In view of the possible association between clear cell histology and VTE in endometrial cancer, we measured the plasma levels of thrombin-antithrombin III complex (TAT) and D-dimer (DD) in the preoperative examinations of a patient with clear cell adenocarcinoma of the endometrium. Plasma TAT and DD were both highly elevated, though the patient had no symptoms of VTE or risk factors such as obesity or diabetes mellitus. Ultrasound Doppler examination and lung perfusion scintigraphy just before surgery revealed a thrombosis in the left popliteal vein and a pulmonary embolism. After implanting an inferior vena cava filter to prevent a fatal embolism of the lung, we performed abdominal total hysterectomy, bilateral salpingo-oophorectomy, and sampling of the pelvic lymph nodes. The VTE gradually disappeared and the plasma levels of TAT and DD returned to normal after surgery. Possibly, the VTE in this patient may have been associated with the clear cell histology.
authors.affiliation: Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Toyoda
authors.forename: Toyomi
authors.initials: T
authors.lastname: Satoh
authors.forename: Katsumi
authors.initials: K
authors.lastname: Takano
authors.forename: Nakako Okada
authors.initials: NO
authors.lastname: Sato
authors.forename: Akinori
authors.initials: A
authors.lastname: Oki
authors.forename: Hajime
authors.initials: H
authors.lastname: Tsunoda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshikawa
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000097:blood / Q000150:complications* / Q000601:surgery; D000368:Aged; D000990:Antithrombin III; D016889:Endometrial Neoplasms / Q000097:blood / Q000150:complications* / Q000601:surgery; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D007044:Hysterectomy; D010052:Ovariectomy; D010447:Peptide Hydrolases / Q000097:blood; D011152:Popliteal Vein; D011300:Preoperative Care; D011655:Pulmonary Embolism / Q000097:blood / Q000150:complications / Q000175:diagnosis; D013923:Thromboembolism / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D020246:Venous Thrombosis / Q000097:blood / Q000150:complications / Q000175:diagnosis
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; D000990:Antithrombin III; D010447:Peptide Hydrolases