Spontaneous arterial thrombosis in a patient with advanced ovarian clear cell cancer: a case report and literature review

J Int Med Res. 2020 Jun;48(6):300060520926742. doi: 10.1177/0300060520926742.

Abstract

Patients with ovarian cancer are often in a hypercoagulable state and have a high risk of venous thrombosis, including deep vein thrombosis and pulmonary embolism. However, arterial thrombosis is relatively rare in ovarian cancer. We report a case a 46-year-old woman with ovarian clear cell carcinoma who developed arterial and venous thrombosis in the lower extremities as the first manifestation. Her arterial thrombosis-related ischemic symptoms were not responsive to anticoagulant treatment of low-molecular-weight heparin, but improved after neoadjuvant chemotherapy and surgery. Therefore, we hypothesize that the optimal therapy for arterial thrombosis in ovarian cancer is treatment for the underlying disease (i.e., ovarian cancer). A thorough investigation is required to determine the relationships between arterial thrombosis and ovarian cancer and antithrombotic treatments for ovarian cancer related-arterial thrombosis.

Keywords: CA125; Ovarian clear cell cancer; antithrombotic treatment; arterial thrombosis; chemotherapy; low-molecular-weight heparin; venous thromboembolism.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma, Clear Cell / complications
  • Adenocarcinoma, Clear Cell / diagnosis*
  • Adenocarcinoma, Clear Cell / secondary
  • Adenocarcinoma, Clear Cell / therapy
  • Arteries / diagnostic imaging
  • Arteries / pathology*
  • Biomarkers, Tumor / blood
  • Biopsy
  • Chemotherapy, Adjuvant
  • Computed Tomography Angiography
  • Female
  • Heparin, Low-Molecular-Weight / administration & dosage
  • Humans
  • Hysterectomy
  • Incidental Findings
  • Lower Extremity / blood supply
  • Middle Aged
  • Neoadjuvant Therapy / methods
  • Neoplasm Staging
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / therapy
  • Ovary / diagnostic imaging
  • Ovary / pathology
  • Ovary / surgery
  • Peritoneal Neoplasms / complications
  • Peritoneal Neoplasms / diagnosis*
  • Peritoneal Neoplasms / secondary
  • Peritoneal Neoplasms / therapy
  • Positron Emission Tomography Computed Tomography
  • Salpingo-oophorectomy
  • Thrombosis / diagnosis*
  • Thrombosis / drug therapy
  • Thrombosis / etiology
  • Treatment Outcome
  • Ultrasonography

Substances

  • Biomarkers, Tumor
  • Heparin, Low-Molecular-Weight