title: Internal Jugular and Subclavian Vein Thrombosis in a Case of Ovarian Cancer.
abstract: Central venous catheter insertion and cancer represent some of the important predisposing factors for deep venous thrombosis (DVT). DVT usually develops in the lower extremities, and venous thrombosis of the upper extremities is uncommon. Early diagnosis and treatment of deep venous thrombosis are of importance, because it is a precursor of complications such as pulmonary embolism and postthrombotic syndrome. A 47-year-old woman visited our department with painful swelling on the left side of her neck. Initial examination revealed swelling of the region extending from the left neck to the shoulder without any redness of the overlying skin. Laboratory tests showed a white blood cell count of 5,800/mm3and an elevated serum C-reactive protein of 4.51 mg/dL. Computed tomography (CT) of the neck revealed a vascular filling defect in the left internal jugular vein to left subclavian vein region, with the venous lumina completely occluded with dense soft tissue. On the basis of the findings, we made the diagnosis of thrombosis of the left internal jugular and left subclavian veins. The patient was begun on treatment with oral rivaroxaban, but the left shoulder pain worsened. She was then admitted to the hospital and treated by balloon thrombectomy and thrombolytic therapy, which led to improvement of the left subclavian venous occlusion. Histopathologic examination of the removed thrombus revealed adenocarcinoma cells, indicating hematogenous dissemination of malignant cells.
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Hiroto
authors.identifier: 0000-0002-3296-2082
authors.initials: H
authors.lastname: Moriwaki
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Nana
authors.initials: N
authors.lastname: Hayama
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Shouko
authors.initials: S
authors.lastname: Morozumi
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Nakano
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Akari
authors.initials: A
authors.lastname: Nakayama
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Yoshiomi
authors.initials: Y
authors.lastname: Takahata
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Yuusuke
authors.initials: Y
authors.lastname: Sakaguchi
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Natsuki
authors.initials: N
authors.lastname: Inoue
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kubota
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Takenoya
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Ishii
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Okubo
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Souta
authors.initials: S
authors.lastname: Yamaguchi
authors.affiliation: Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ono
authors.affiliation: Department of Pathology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Oharaseki
authors.affiliation: Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Yoshikawa