Abstract

Introduction: Deep vein thrombosis is a frequent disease, its origin is most often multifactorial. Venous thromboembolic disease (MVTE) and cancer are two frequently entangled pathologies. Here we report the diagnosis of deep vein thrombosis that discovered prostate cancer in an 88-year-old Guinean man. On clinical examination, there was a painful and hot swelling of the right leg, an absence of sloshing of the calf, a positive sign of Homans. The digital rectal examination revealed an enlarged prostate with an irregular surface. Cardiopulmonary auscultation was normal. The electrocardiogram showed a regular sinus rhythm at 65 cycles/min, with no sign of enlarged cavities or conduction disturbance. Venous Doppler ultrasound of the lower limbs showed the presence of an extensive acute deep venous thrombosis of the right sural vein extended to the popliteal and to the homolateral deep femoral. The reino-vesico-prostatic ultrasound concluded in a heterogeneous prostatic hypertrophy with projection of a median lobe associated with a bladder of fight with an important post voiding residue evaluated at 170 ml; the rate of specific antigen of the prostate PSA was at 84.87 ng/ml. The pathology analysis made after a prostate biopsy puncture concluded with an adenocarcinoma with a Gleason score of 3. Conclusion: The association of venous thromboembolic disease (MVTE) and neoplasia is frequent. The existence of active cancer in a patient is a known risk factor for MVTE and, conversely, the discovery of a first episode of deep vein thrombosis (DVT) or pulmonary embolism (PE) may be the mode of revelation of cancer.

Highlights

  • IntroductionVenous thrombosis is a frequent disease; its origin is most often multifactorial

  • Deep vein thrombosis is a frequent disease, its origin is most often multifactorial

  • The reino-vesico-prostatic ultrasound concluded in a heterogeneous prostatic hypertrophy with projection of a median lobe associated with a bladder of fight with an important post voiding residue evaluated at 170 ml; the rate of specific antigen of the prostate PSA was at 84.87 ng/ml

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Summary

Introduction

Venous thrombosis is a frequent disease; its origin is most often multifactorial. Venous thromboembolic disease (MVTE) and cancer are two frequently entangled pathologies. Cancer is present in almost 20% of patients with MVTE and it is even likely to be the first sign of tumor pathology [4]. Cancer patients very often combine several acquired risk factors for MVTE: bed rest, surgery, immobilization, extrinsic venous compression, etc., certain specific cancer treatments, such as chemotherapy [5]. In Guinea, a study carried out in 2016 found 40 cases of venous thrombosis, i.e. 13% of the hospitalization rate [6]. Many factors are involved in the occurrence of venous thrombosis among which we have cancers, hemopathies; the frequency of thrombosis in cancer patients is 5 - 10 [1] [7]. The objective of this study was to report a case of deep vein thrombosis of the right lower limb linked to prostate cancer, to underline the importance of systematic screening for prostate cancer before a deep vein thrombosis especially in the elderly

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