akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347.2017.11.3.088-093akusherstvo-430Research ArticleCLINICAL CASEКЛИНИЧЕСКИЙ СЛУЧАЙRARE THROMBOSIS LOCALIZATION IN A CANCER PATIENT WITH COMBINED THROMBOPHILIA: A CLINICAL CASEКЛИНИЧЕСКИЙ СЛУЧАЙ ТРОМБОЗА РЕДКОЙ ЛОКАЛИЗАЦИИ У ОНКОЛОГИЧЕСКОЙ ПАЦИЕНТКИ С СОЧЕТАННОЙ ФОРМОЙ ТРОМБОФИЛИИВоробьевА. В.VorobievA. V.

Воробьев Александр Викторович – кандидат медицинских наук, доцент кафедры акушерства и гинекологии медико-профилактического факультета.

Ул. Земляной Вал, 62, стр. 1, Москва, 109004

Vorobiev Alexander Viktorovich – PhD, Associate Professor,  Department of Obstetrics and Gynecology, Faculty of Preventive Medicine.

Ul. Zemlyanoi val, 62, Moscow, 109004

alvorobev@gmail.comМакацарияА. Д.MakatsariaA. D.

Макацария Александр Давидович – доктор медицинских наук, член-корреспондент  РАН, профессор, зав. кафедрой акушерства и гинекологии медико-профилактического факультета.

Ул. Земляной Вал, 62, стр. 1, Москва, 109004

Makatsariya  Aleksander  Davidovich – MD, Corresponding Member of RAS,  Professor, Head of Department of Obstetrics and Gynecology, Faculty of Preventive  Medicine.

Ul. Zemlyanoi val, 62, Moscow, 109004

gemostasis@mail.ruФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University, Health Ministry of Russian FederationRussian Federation2017061220171138893Copyright © Vorobiev A.V., Makatsaria A.D., 20172017Воробьев А.В., Макацария А.Д.Vorobiev A.V., Makatsaria A.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/430

This report presents a rare case of thrombophilia – thrombosis of the ovarian vein in combination with thrombosis  of the right common iliac vein. The symptoms were initially interpreted  as acute appendicitis that led to the decision to perform laparoscopy. Thereafter, a different diagnosis – acute endometritis, acute salpingo-oophoritis – was proposed. As the subsequent treatment resulted in no improvement, a CT scan was performed to detect thrombi of a typical localizations and a mass in the uterus area, which turned out to be a poor-differentiated adenocarcinoma. In the patient’s medical history, multiple signs of family thrombophilia were found; further laboratory tests also pointed to the diagnosis of thrombophilia. Considering the previously performed surgery and the confirmed thrombophilia of rare localization, permanent anticoagulant therapy was recommended.

В статье описан клинический случай редкой формы тромбоза – тромбоз яичниковой  вены в сочетании с тромбозом правой общей подвздошной вены. Симптомы изначально были трактованы как острый аппендицит, по поводу чего была проведена лапароскопия, по итогам которой был установлен диагноз «острый эндометрит, острый сальпингоофорит».  На фоне терапии без динамики была проведена  КТ, и обнаружены тромбозы нетипичных локализаций, а также  образование в области  матки, оказавшееся низкодифференцированной  аденокарциномой. При изучении анамнестических данных были выявлены многочисленные указания на наличие семейной тромбофилии, что  и было подтверждено лабораторными  исследованиями. С учетом  проведенного хирургического лечения и выявленной сочетанной формы тромбофилии была рекомендована перманентная антикоагулянтная терапия.

тромбоз редкой локализациигенетическая и приобретенная тромбофилияантикоагулянтная терапиязлокачественные новообразованиятромботические осложненияпатогенез тромботических осложненийонкологические больныепрофилактика тромбозовнарушения гемостазаthrombosis of rare localizationgenetic thrombophiliaacquired thrombophiliaanticoagulant therapymalignant neoplasmsthrombotic complicationspathogenesis of thrombotic complicationscancer patientprevention of thrombosishemostasis disordersReferencesKeeling D., Klok F.A., Le Gal G. Controversies in venous thromboembolism. 2015. Blood Rev. 2016; 30 (1): 27-33.Keeling D., Klok F.A., Le Gal G. Controversies in venous thromboembolism. 2015. Blood Rev. 2016; 30 (1): 27-33.Thalin C., Blomgren B., Mobarrez F., Lundstrom A., Laska A.C., von Arbin M. et al. Trousseau's Syndrome, a Previously Unrecognized Condition in Acute Ischemic Stroke Associated With Myocardial Injury. J Investig Med High Impact Case Rep. 2014; 2 (2): 1-6.Thalin C., Blomgren B., Mobarrez F., Lundstrom A., Laska A.C., von Arbin M. et al. Trousseau's Syndrome, a Previously Unrecognized Condition in Acute Ischemic Stroke Associated With Myocardial Injury. J Investig Med High Impact Case Rep. 2014; 2 (2): 1-6.Semb V.B., Tveit A. Limited malignancy screening of patients with idiopathic venous thromboembolism. Tidsskr Nor Laegeforen. 2014; 134 (4): 407-1.Semb V.B., Tveit A. Limited malignancy screening of patients with idiopathic venous thromboembolism. Tidsskr Nor Laegeforen. 2014; 134 (4): 407-1.Sebastiani G.D., Iuliano A., Cantarini L., Galeazzi M. Genetic aspects of the antiphospholipid syndrome: An update. Autoimmun Rev. 2016; 15 (5): 433-9.Sebastiani G.D., Iuliano A., Cantarini L., Galeazzi M. Genetic aspects of the antiphospholipid syndrome: An update. Autoimmun Rev. 2016; 15 (5): 433-9.Chen F., Wang M.J., Li J., Yan C.E., Han X.H., Wu Z.Y., Qi J. Plasma D-dimer value as a predictor of malignant lymph node involvement in operable non-small cell lung cancer. Tumour Biol. 2015; 36 (12): 9201-7.Chen F., Wang M.J., Li J., Yan C.E., Han X.H., Wu Z.Y., Qi J. Plasma D-dimer value as a predictor of malignant lymph node involvement in operable non-small cell lung cancer. Tumour Biol. 2015; 36 (12): 9201-7.Zhang M.H., Xu X.H., Wang Y., Linq Q.X., Bi Y.T., Miao X.J. et al. A prognostic biomarker for gastric cancer with lymph node metastases. Anat Rec (Hoboken).Zhang M.H., Xu X.H., Wang Y., Linq Q.X., Bi Y.T., Miao X.J. et al. A prognostic biomarker for gastric cancer with lymph node metastases. Anat Rec (Hoboken).Tozzoli R., D'Aurizio F., Falcomer F., Basso S.M., Lumachi F. Serum Tumor Markers in Stage I-II Breast Cancer. Med Chem. 2016; 12 (3): 285-9.Tozzoli R., D'Aurizio F., Falcomer F., Basso S.M., Lumachi F. Serum Tumor Markers in Stage I-II Breast Cancer. Med Chem. 2016; 12 (3): 285-9.Martínez-Lostao L., Anel A., Pardo J. How Do Cytotoxic Lymphocytes Kill Cancer Cells? Clin Cancer Res. 2015; 21 (22): 5047-56.Martínez-Lostao L., Anel A., Pardo J. How Do Cytotoxic Lymphocytes Kill Cancer Cells? Clin Cancer Res. 2015; 21 (22): 5047-56.Duffy M.J., McGowan P.M., Harbeck N., Thomssen C., Schmitt M. uPA and PAI-1 as biomarkers in breast cancer: validated for clinical use in level-of-evidence-1 studies. Breast Cancer Res. 2014; 16 (4): 428.Duffy M.J., McGowan P.M., Harbeck N., Thomssen C., Schmitt M. uPA and PAI-1 as biomarkers in breast cancer: validated for clinical use in level-of-evidence-1 studies. Breast Cancer Res. 2014; 16 (4): 428.Ansari D., Ansari D., Andersson R., Andrén-Sandberg A. Pancreatic cancer and thromboembolic disease, 150 years after Trousseau. Hepatobiliary Surg Nutr. 2015; 4 (5): 325-35.Ansari D., Ansari D., Andersson R., Andrén-Sandberg A. Pancreatic cancer and thromboembolic disease, 150 years after Trousseau. Hepatobiliary Surg Nutr. 2015; 4 (5): 325-35.Couturaud F., Meyer G., Mottier D. Thrombophilia and the Risk of Recurrent Venous Thromboembolism – Reply. JAMA. 2015; 314 (18): 1976.Couturaud F., Meyer G., Mottier D. Thrombophilia and the Risk of Recurrent Venous Thromboembolism – Reply. JAMA. 2015; 314 (18): 1976.Pabinger I., Ay C., Dunkler D., Thaler J., Reitter E.M., Marosi C. et al. Factor V Leiden mutation increases the risk for venous thromboembolism in cancer patients – results from the Vienna Cancer And Thrombosis Study (CATS). J Thromb Haemost. 2015; 13 (1): 17-22.Pabinger I., Ay C., Dunkler D., Thaler J., Reitter E.M., Marosi C. et al. Factor V Leiden mutation increases the risk for venous thromboembolism in cancer patients – results from the Vienna Cancer And Thrombosis Study (CATS). J Thromb Haemost. 2015; 13 (1): 17-22.Kovac M., Kovac Z., Tomasevic Z., Vucicevic S., Djordjevic V., Pruner I., Radojkovic D. Factor V Leiden mutation and high FVIII are associated with an increased risk of VTE in women with breast cancer during adjuvant tamoxifen – results from a prospective, single center, case control study. Eur J Intern Med. 2015; 26 (1): 63-7.Kovac M., Kovac Z., Tomasevic Z., Vucicevic S., Djordjevic V., Pruner I., Radojkovic D. Factor V Leiden mutation and high FVIII are associated with an increased risk of VTE in women with breast cancer during adjuvant tamoxifen – results from a prospective, single center, case control study. Eur J Intern Med. 2015; 26 (1): 63-7.Segers O., Simioni P., Tormene D., Bulato C., Gavasso S., Rosing J., Castoldi E. Genetic modulation of the FV(Leiden)/normal FV ratio and risk of venous thrombosis in factor V Leiden heterozygotes. J Thromb Haemost. 2012; 10 (1): 73-80.Segers O., Simioni P., Tormene D., Bulato C., Gavasso S., Rosing J., Castoldi E. Genetic modulation of the FV(Leiden)/normal FV ratio and risk of venous thrombosis in factor V Leiden heterozygotes. J Thromb Haemost. 2012; 10 (1): 73-80.Cooper P.C., Rezende S.M. An overview of methods for detection of factor V Leiden and the prothrombin G20210A mutations. Int J Lab Hematol. 2007; 29 (3): 153-62.Cooper P.C., Rezende S.M. An overview of methods for detection of factor V Leiden and the prothrombin G20210A mutations. Int J Lab Hematol. 2007; 29 (3): 153-62.White C.W., Thomason A.R., Prince V. Recurrent venous thromboembolism in a patient with heterozygous factor V Leiden mutation. Hosp Pharm. 2014; 49 (8): 748-51.White C.W., Thomason A.R., Prince V. Recurrent venous thromboembolism in a patient with heterozygous factor V Leiden mutation. Hosp Pharm. 2014; 49 (8): 748-51.Zhang P., Zhang J., Sun G., Gao X., Wang H., Yan W. et al. Risk of Budd-Chiari syndrome associated with factor V Leiden and G20210A prothrombin mutation: a meta-analysis. PLoS One. 2014; 9 (4): e95719.Zhang P., Zhang J., Sun G., Gao X., Wang H., Yan W. et al. Risk of Budd-Chiari syndrome associated with factor V Leiden and G20210A prothrombin mutation: a meta-analysis. PLoS One. 2014; 9 (4): e95719.Van Cott E.M., Khor B., Zehnder J.L. Factor V Leiden. Am J Hematol. 2016; 91 (1): 46-9.Van Cott E.M., Khor B., Zehnder J.L. Factor V Leiden. Am J Hematol. 2016; 91 (1): 46-9.Naushad S.M., Reddy C.A., Kumaraswami K., Divyya S., Kotamraju S., Gottumukkala S.R., Digumarti R.R., Kutala V.K. Impact of hyperhomocysteinemia on breast cancer initiation and progression: epigenetic perspective. Cell Biochem Biophys. 2014; 68 (2): 397-406.Naushad S.M., Reddy C.A., Kumaraswami K., Divyya S., Kotamraju S., Gottumukkala S.R., Digumarti R.R., Kutala V.K. Impact of hyperhomocysteinemia on breast cancer initiation and progression: epigenetic perspective. Cell Biochem Biophys. 2014; 68 (2): 397-406.Heit J.A. Predicting the risk of venous thromboembolism recurrence. Am J Hematol. 2012; 87 (Suppl 1): S63-7.Heit J.A. Predicting the risk of venous thromboembolism recurrence. Am J Hematol. 2012; 87 (Suppl 1): S63-7.Falanga A., Russo L., Milesi V. The coagulopathy of cancer. Curr Opin Hematol. 2014; 21 (5): 423-9.Falanga A., Russo L., Milesi V. The coagulopathy of cancer. Curr Opin Hematol. 2014; 21 (5): 423-9.Levi M. Cancer-related coagulopathies. Thromb Res. 2014; 133 (Suppl 2): S70-5.Levi M. Cancer-related coagulopathies. Thromb Res. 2014; 133 (Suppl 2): S70-5.Li N. Platelets in cancer metastasis: To help the «villain» to do evil. IntJCancer. 2016; 138 (9): 2078-87.Li N. Platelets in cancer metastasis: To help the «villain» to do evil. IntJCancer. 2016; 138 (9): 2078-87.

The authors declare that there are no conflicts of interest present.