Tumour thrombus of the inferior vena cava extending into the right atrium in the setting of colon cancer

BMJ Case Reports - Trang bcr2016218107
Daniel E. Meyers1, Nancy Nixon2, Angela Franko3, Danny Siu‐Chun Ng3, Vincent C. Tam4
1University of Calgary, calgary, Alberta, canada
2nancy.a.nixon{at}albertahealthservices.ca
3Foothills Medical Centre, Calgary, Alberta, Canada
4Tom Baker Cancer Centre, Calgary, Alberta, Canada

Tóm tắt

Tumour thrombus is seen in renal cell and hepatocellular carcinoma, but is rarely reported in colorectal cancer. A woman aged 46 years, with metastatic colonic adenocarcinoma, was found to have a large mass in the inferior vena cava (IVC) extending into the right atrium. Although this lesion was initially thought to be bland thrombus, imaging with contrast-enhanced CT scan and contrast-enhanced ultrasound supported the diagnosis of tumour thrombus. Despite the large size of the lesion, the patient was asymptomatic. Her lack of symptoms, and poor overall prognosis from her cancer led to the decision to avoid aggressive surgical or radiological interventions. Several months later, the patient passed away. At autopsy, there was no evidence of fatal embolisation from the pre-existing thrombus. Diagnosis of tumour thrombus in the IVC is difficult and management can be challenging due to the significant risks associated with treatment options.

Từ khóa


Tài liệu tham khảo

Otani K , Ishihara S , Hata K , et al . Colorectal cancer with venous tumor thrombosis. Asian J Surg 2016;1–6.

10.3322/caac.21220

Canadian Cancer Society's Advisory Committee on Cancer Statistics. Canadian Cancer Statistics 2015. Toronto, ON: Canadian Cancer Society, 2015.

10.1016/j.eururo.2015.01.005

Quirk, 2015, Management of hepatocellular carcinoma with portal vein thrombosis, World J Gastroenterol, 21, 3462, 10.3748/wjg.v21.i12.3462

10.1001/archinte.160.6.809

Lee, 1999, The thrombophilic state induced by therapeutic agents in the cancer patient, Semin Thromb Hemost, 25, 137, 10.1055/s-2007-994915

10.1097/00004728-199203000-00012

10.1097/01.cej.0000220641.46470.77

Lee, 2013, The value of 18F-FDG PET/contrast-enhanced CT in detection of tumour thrombus, Clin Nucl Med, 38, e60, 10.1097/RLU.0b013e318266d53e

10.1097/01.rlu.0000159680.66566.b7

10.1200/JCO.2004.10.160

Minagawa, 2006, Treatment of hepatocellular carcinoma accompanied by portal vein tumor thrombus, World J Gastroenterol, 12, 7561, 10.3748/wjg.v12.i47.7561

10.1136/gut.48.1.103

10.1055/s-0030-1247133

10.1002/hep.24199

10.1016/j.jhep.2011.12.001

10.1245/s10434-010-0940-4

10.1245/ASO.2006.08.007

Matsumoto, 2009, Portal vein tumor thrombus from colorectal cancer with no definite metastatic nodules in liver parenchyma, J Hepatobil Pancreat Surg, 16, 688, 10.1007/s00534-009-0061-2

Jimi, 2012, A case of rectal cancer accompanied by tumor thrombus in the inferior mesenteric vein, Jpn J Gastroenterol Surg, 45, 1066, 10.5833/jjgs.45.1066

Thông tin
Thông tin xuất bản

BMJ Case Reports

bcr2016218107

Thông tin tác giả