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Synchronous Ovarian and Endometrial Endometrioid Adenocarcinoma Presenting with Nonbacterial Thrombotic Endocarditis and Pulmonary Thromboembolism: Adenocarcinoma with Thrombotic Events.

Erturk NK, Erturk A, Basaran D, Ozgul N - Case Rep Obstet Gynecol (2015)

Bottom Line: She was scheduled for surgery under enoxaparin.These disorders could be resistant to routine anticoagulant treatment.In case of a thrombotic complication due to ovarian malignancy, surgical resection of the primary tumor may increase the effect of anticoagulant treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Gynecology and Obstetrics, Hacettepe University Faculty of Medicine, 6530 Ankara, Turkey.

ABSTRACT
Introduction. Nonbacterial thrombotic endocarditis (NBTE) is a rare manifestation of hypercoagulability in patients with malignant neoplasms. Case Report. A fifty-six-year-old woman presented to the emergency service; the clinical workup revealed deep vein thrombosis in right leg and bilateral massive PTE. As the abdominal sections on the spiral CT revealed a giant pelvic mass of ovarian origin, she was referred to our hospital's gynecologic oncology department. She was scheduled for surgery under enoxaparin. She described numbness on one side of her face. Cranial imaging findings revealed acute ischemic cerebral lesions and transesophageal echocardiogram showed vegetation on the aortic cusp. Under anticoagulation treatment, she underwent hysterectomy with bilateral salpingo-oophorectomy and infracolic omentectomy. After tumor resection, her neurological symptoms dissolved with aggressive anticoagulant treatment. Pathology result was synchronous endometrial and ovarian adenocarcinoma. Discussion. NBTE is a rare condition often associated with advanced malignancies. Peripheral embolism and venous thrombosis are complications that have been associated with NBTE due to hypercoagulable state. These disorders could be resistant to routine anticoagulant treatment. In case of a thrombotic complication due to ovarian malignancy, surgical resection of the primary tumor may increase the effect of anticoagulant treatment.

No MeSH data available.


Related in: MedlinePlus

Abdominal computerized tomography revealed a complicated pelvic mass of ovarian origin (arrows).
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fig1: Abdominal computerized tomography revealed a complicated pelvic mass of ovarian origin (arrows).

Mentions: A fifty-six-year-old igravid woman was admitted to the emergency service of a community hospital with shortness of breath and mild chest pain. The clinical workup revealed deep vein thrombosis in her right leg and bilateral massive PTE. As the abdominal sections on the spiral computerized tomography (CT) scan revealed a giant pelvic mass of ovarian origin with septa, solid component, and ascites, she was referred to our hospital's gynecologic oncology department after initial anticoagulant treatment with unfractionated intravenous (IV) heparin. Her initial examination was remarkable for pelvic mass up to the level of umbilicus and mild orthopnea. In the repeated abdominal CT scan, a 165 × 130 × 90 mm solid cystic mass probably originated from the left ovary, ascites, and splenic infarcts were seen (Figure 1). Her CA-125 value was 23000 U/mL, fibrinogen was 795 mg/dL, and D-Dimer was 20 mg/dL. After consultation with our pulmonology department, she was scheduled for surgery under enoxaparin 0.8 mL b.i.d.


Synchronous Ovarian and Endometrial Endometrioid Adenocarcinoma Presenting with Nonbacterial Thrombotic Endocarditis and Pulmonary Thromboembolism: Adenocarcinoma with Thrombotic Events.

Erturk NK, Erturk A, Basaran D, Ozgul N - Case Rep Obstet Gynecol (2015)

Abdominal computerized tomography revealed a complicated pelvic mass of ovarian origin (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4631876&req=5

fig1: Abdominal computerized tomography revealed a complicated pelvic mass of ovarian origin (arrows).
Mentions: A fifty-six-year-old igravid woman was admitted to the emergency service of a community hospital with shortness of breath and mild chest pain. The clinical workup revealed deep vein thrombosis in her right leg and bilateral massive PTE. As the abdominal sections on the spiral computerized tomography (CT) scan revealed a giant pelvic mass of ovarian origin with septa, solid component, and ascites, she was referred to our hospital's gynecologic oncology department after initial anticoagulant treatment with unfractionated intravenous (IV) heparin. Her initial examination was remarkable for pelvic mass up to the level of umbilicus and mild orthopnea. In the repeated abdominal CT scan, a 165 × 130 × 90 mm solid cystic mass probably originated from the left ovary, ascites, and splenic infarcts were seen (Figure 1). Her CA-125 value was 23000 U/mL, fibrinogen was 795 mg/dL, and D-Dimer was 20 mg/dL. After consultation with our pulmonology department, she was scheduled for surgery under enoxaparin 0.8 mL b.i.d.

Bottom Line: She was scheduled for surgery under enoxaparin.These disorders could be resistant to routine anticoagulant treatment.In case of a thrombotic complication due to ovarian malignancy, surgical resection of the primary tumor may increase the effect of anticoagulant treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Gynecology and Obstetrics, Hacettepe University Faculty of Medicine, 6530 Ankara, Turkey.

ABSTRACT
Introduction. Nonbacterial thrombotic endocarditis (NBTE) is a rare manifestation of hypercoagulability in patients with malignant neoplasms. Case Report. A fifty-six-year-old woman presented to the emergency service; the clinical workup revealed deep vein thrombosis in right leg and bilateral massive PTE. As the abdominal sections on the spiral CT revealed a giant pelvic mass of ovarian origin, she was referred to our hospital's gynecologic oncology department. She was scheduled for surgery under enoxaparin. She described numbness on one side of her face. Cranial imaging findings revealed acute ischemic cerebral lesions and transesophageal echocardiogram showed vegetation on the aortic cusp. Under anticoagulation treatment, she underwent hysterectomy with bilateral salpingo-oophorectomy and infracolic omentectomy. After tumor resection, her neurological symptoms dissolved with aggressive anticoagulant treatment. Pathology result was synchronous endometrial and ovarian adenocarcinoma. Discussion. NBTE is a rare condition often associated with advanced malignancies. Peripheral embolism and venous thrombosis are complications that have been associated with NBTE due to hypercoagulable state. These disorders could be resistant to routine anticoagulant treatment. In case of a thrombotic complication due to ovarian malignancy, surgical resection of the primary tumor may increase the effect of anticoagulant treatment.

No MeSH data available.


Related in: MedlinePlus