A rare case of ovarian vein thrombosis in a gestational trophoblastic neoplasia patient
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Ovarian vein thrombosis (OVT) is a rare disease with complications that can be life-threatening. An ovarian veinthrombus in a gestational trophoblastic neoplasia (GTN) is an extremely rare condition that has not been previouslyreported in the literature. We report the case of a 23-year-old woman who presented with symptoms of amenorrheafor 15 weeks and 6 days along with intermittent lower abdominal pain. She was diagnosed with a hydatidiform mole,and a metastatic workup was scheduled. Abdominal computed tomography showed a right ovarian vein thrombus. She received methotrexate chemotherapy combined with oral anticoagulants. Complete radiological remission wasobtained. During the 12-month follow-up period, no disease progression or recurrence was noted. Early recognitionand detection of the condition are of the utmost importance. The differential diagnosis of OVT must be consideredwhen there is unexplained abdominal pain, fever, and leukocytosis during the diagnosis and treatment of GTN. Ahigh level of suspicion is required for prompt diagnosis of OVT.
Abstract
Ovarian vein thrombosis (OVT) is a rare disease with complications that can be life-threatening. An ovarian veinthrombus in a gestational trophoblastic neoplasia (GTN) is an extremely rare condition that has not been previouslyreported in the literature. We report the case of a 23-year-old woman who presented with symptoms of amenorrheafor 15 weeks and 6 days along with intermittent lower abdominal pain. She was diagnosed with a hydatidiform mole,and a metastatic workup was scheduled. Abdominal computed tomography showed a right ovarian vein thrombus. She received methotrexate chemotherapy combined with oral anticoagulants. Complete radiological remission wasobtained. During the 12-month follow-up period, no disease progression or recurrence was noted. Early recognitionand detection of the condition are of the utmost importance. The differential diagnosis of OVT must be consideredwhen there is unexplained abdominal pain, fever, and leukocytosis during the diagnosis and treatment of GTN. Ahigh level of suspicion is required for prompt diagnosis of OVT.
참고문헌 (15)
- Brown TK, "Puerperal ovarian vein thrombophlebitis : a syndrome", Am J Obstet Gynecol, 109, pp.263~273 (1971)
- André M, "Ovarian vein thrombosis in the antiphospholipid syndrome", Arthritis Rheum, 50, pp.183~186 (2004)
- Heavrin BS, "Ovarian vein thrombosis : a rare cause of abdominal pain outside the peripartum period", J Emerg Med, 34, pp.67~69 (2008)
- Jacoby WT, "Ovarian vein thrombosis in oncology patients : CT detection and clinical significance", AJR Am J Roentgenol, 155, pp.291~294 (1990)
- Klima DA, "Postpartum ovarian vein thrombosis", Obstet Gynecol, 111, pp.431~435 (2008)
- Marcovici I, "Ovarian vein thrombosis associated with Crohn’s disease : a case report", Am J Obstet Gynecol, 182, pp.743~744 (2000)
- Salomon O, "Risk factors associated with postpartum ovarian vein thrombosis", Thromb Haemost, 82, pp.1015~1019 (1999)
- Simons GR, "Ovarian vein thrombosis", Am Heart J, 126, pp.641~647 (1993)
- Austin OG, "Massive thrombophlebitis of the ovarian veins; a case report", Am J Obstet Gynecol, 72, pp.428~429 (1956)
- Calderwood CJ, "Gestational related changes in the deep venous system of the lower limb on light reflection rheography in pregnancy and the puerperium", Clin Radiol, 62, pp.1174~1179 (2007)
- Harris K, "Ovarian vein thrombosis in the nonpregnant woman : an overlooked diagnosis", Ther Adv Hematol, 3, pp.325~328 (2012)
- Kubik-Huch RA, "Role of duplex color Doppler ultrasound, computed tomography, and MR angiography in the diagnosis of septic puerperal ovarian vein thrombosis", Abdom Imaging, 24, pp.85~91 (1999)
- Wysokinska EM, "Ovarian vein thrombosis : incidence of recurrent venous thromboembolism and survival", Thromb Haemost, 96, pp.126~131 (2006)
- Kearon C, "Antithrombotic therapy for VTE disease : CHEST guideline and expert panel report", Chest, 149, pp.315~352 (2016)
- EINSTEIN Investigators, "Oral rivaroxaban for symptomatic venous thromboembolism", N Engl J Med, 363, pp.2499~2510 (2010)