Korean J Hematol.  2012 Sep;47(3):233-236. 10.5045/kjh.2012.47.3.233.

Thromboembolic events identified during diagnosis of germ cell tumors in 2 children

• Oh HL
• Kang HR
• Jeon SC
• Lee YH

• KMID: 2251960
• DOI: http://doi.org/10.5045/kjh.2012.47.3.233

Abstract

We describe 2 cases in which radiographic evidence of thromboembolic events was obtained during germ cell tumor diagnosis. There was no evidence of coagulation factor abnormalities or contributory procedures or drugs in either patient. We used anticoagulation therapy for thrombolysis in one patient, but in the other, the thromboembolism resolved spontaneously.

Keyword

Thromboembolism; Germ cell tumor; Chemotherapy

MeSH Terms

Blood Coagulation Factors
Child
Germ Cells
Humans
Neoplasms, Germ Cell and Embryonal
Thromboembolism
Blood Coagulation Factors

Figure

• 

  Fig. 1 Initial neck Doppler ultrasonography revealing an expansile thrombus in the right jugular vein (A, arrow). Three months after the completion of chemotherapy, the thrombus disappeared and the flow in the vein normalized (B, arrow).

• 

  Fig. 2 Chest computed tomography showing a pulmonary thromboembolism in the main, lateral, and posterior basal segmental pulmonary artery on the right lower lobe (A, arrow). The thromboembolism resolved after 2 weeks of heparin and warfarin therapy (B, arrow).

Reference

1. Thodiyil PA, Kakkar AK. Variation in relative risk of venous thromboembolism in different cancers. Thromb Haemost. 2002. 87:1076–1077.

2. Piketty AC, Fléchon A, Laplanche A, et al. The risk of thromboembolic events is increased in patients with germ-cell tumours and can be predicted by serum lactate dehydrogenase and body surface area. Br J Cancer. 2005. 93:909–914.

3. Jafri M, Protheroe A. Cisplatin-associated thrombosis. Anticancer Drugs. 2008. 19:927–929.

4. Mitomi M, Kimura K, Iguchi Y, et al. A case of stroke due to tumor emboli associated with metastatic cardiac liposarcoma. Intern Med. 2011. 50:1489–1491.

5. Stergiopoulos K, Vasu S, Bilfinger T, Poon M. Embolic stroke in a patient with metastatic renal cell cancer. Hellenic J Cardiol. 2011. 52:256–258.

6. Abdel-Razeq HN, Mansour AH, Ismael YM. Incidental pulmonary embolism in cancer patients: clinical characteristics and outcome-a comprehensive cancer center experience. Vasc Health Risk Manag. 2011. 7:153–158.

7. Natsuaki M, Numaguchi K, Tada H, Nakashima Y, Okabe M, Yamamoto Y. Recurrence of pulmonary embolism in young man with retroperitoneal tumor despite insertion of temporary IVC filter. Circ J. 2009. 73:1756–1758.

8. Dijk FN, Curtin J, Lord D, Fitzgerald DA. Pulmonary embolism in children. Paediatr Respir Rev. 2012. 13:112–122.

9. Oschman A, Kuhn RJ. Venous thromboembolism in the pediatric population. Orthopedics. 2010. 33:180–184.

10. Latorre González G, López de Silanes de Miguel C, Escribano Gascón AB. Cerebral venous thrombosis in a chemotherapy patient with dysgerminoma. An Pediatr (Barc). 2008. 69:485–486.

11. Cyriac S, Sagar TG, Mahajan V. Choriocarcinoma with arterial and venous thrombosis. Neurol India. 2009. 57:505–507.

12. Zhou W, Ding SF. Concurrent pheochromocytoma, ventricular tachycardia, left ventricular thrombus, and systemic embolization. Intern Med. 2009. 48:1015–1019.

13. Owen RJ. Embolization of musculoskeletal bone tumors. Semin Intervent Radiol. 2010. 27:111–123.

14. Simanek R, Vormittag R, Hassler M, et al. Venous thromboembolism and survival in patients with high-grade glioma. Neuro Oncol. 2007. 9:89–95.

15. Moheimani F, Jackson DE. Venous thromboembolism: classification, risk factors, diagnosis, and management. ISRN Hematol. 2011. 2011:124610.