An Important Factor In Etiology Of Deep Venous Thrombosis: Malignancy

Abstract

Purpose: To determine the frequency of subsequent malignancy in patients with deep venous thrombosis and to evaluate them in accordance with literature data. Material and Method: We studied 212 consecutive patients with confirmed deep venous thrombosis of the lower extremity between January 2001 and March 2003 at our department. We analysed records from malignancy detected patients and results were discussed. Findings: Twenty-one patients had a malignancy (9.9%). Mean age was 57.7 (35-72) and male to female ratio was 10/11. The most frequently detected malignancies were gynecologic (33.3 %) and pulmonary neoplasias (28.5 %). Gastrointestinal (GI) (14.3 %) and urologic (14.3 %) malignancies were less commonly observed. Gynecologic malignancies were localized to the uterus (n=4), ovaries (n=2) and vulva (n=1). Pulmonary malignancies were small cell cancer (n=4) and epidermoid cancer (n=2). GI neoplasias were all localized to the colon. Of 3 urologic malignancies, 2 were hypernephroma and 1 was a prostate cancer. Venous thromboses were localized most commonly to the femoral vein (85.7%). Hemoglobin, thrombocyte and albumin levels were found to be significantly lower in the malignancy group compared to other group (p< 0.05). Protein C, protein S and antithrombin 3 levels did not differ among groups, however carcinoembryonic antigen levels were significantly higher in malignancy group (p< 0.05) . Results: Deep venous thrombosis is associated with a significantly higher frequency of malignancy. The results suggest that detailed screening especially for gynecologic and pulmonary malignancies is necessary in patients with no known risk factor for hypercoagulability.