Particular aspects in patients with paraneoplastic deep vein thrombosis: from a shadowy diagnosis to a routinely met pathology

Abstract

The oncological patient presents many pathophysiological particularities, including a hypercoagulable state, which causes frequent thromboembolic complications. Furthermore, the side effects of chemotherapy, laborious surgical interventions and the poor performance status favor the occurrence of deep vein thrombosis (DVT). The aim of this retrospective study is to identify the prevalence of paraneoplastic DVT in patients admitted in the Cardiology Department of the “Sf. Spiridon” County Clinical Emergency Hospital from Iași and to establish the correlations between the DVT, type of neoplasia and certain particularities of the patients. Material and methods: The current retrospective study was conducted over a two-year period and enrolled 100 patients divided into two groups based on the presence or absence of a neoplasia (25 patients having a tumoral pathology and 75 patients without such a comorbidity). All study participants underwent a complete clinical examination and were assessed through biochemical and echocardiographic parameters. Results: Various tumor locations were identified in the 25 patients with a malignancy, the most prevalent being the colorectal cancer (6 cases, 24% of total), followed by the lung cancer (4 cases, 16%) and, with a similar occurrence, the brain, ovarian and breast cancer (2 cases each, 8%). Among the patients with neoplasia, 13 had a history of cancer (52% of cases from the neoplasia group), while for the remaining 12 patients it was a de novo diagnosis. Conclusions: Patients with DVT showed a significant cancer prevalence, either previously diagnosed or incidentally discovered. The increased risk of DVT in cancer patients is multifactorial and represents a diagnosis and therapeutic challenge. In our study, we recorded a slightly increased prevalence of cancer in women (56% vs. 44%), who had cervical cancer as the most common etiology (35.7%). On the other hand, male sex was associated with an increased frequency of colorectal cancer (36.4% of all cancers diagnosed in men), followed by lung cancer (27.3%).