Obstet Gynecol Sci.  2019 May;62(3):190-193. 10.5468/ogs.2019.62.3.190.

A rare case of ovarian vein thrombosis in a gestational trophoblastic neoplasia patient

• Kim IY
• Kim SH
• Hwang IT
• Ha JG
• Cha JH

• KMID: 2445079
• DOI: http://doi.org/10.5468/ogs.2019.62.3.190

Abstract

Ovarian vein thrombosis (OVT) is a rare disease with complications that can be life-threatening. An ovarian vein thrombus in a gestational trophoblastic neoplasia (GTN) is an extremely rare condition that has not been previously reported in the literature. We report the case of a 23-year-old woman who presented with symptoms of amenorrhea for 15 weeks and 6 days along with intermittent lower abdominal pain. She was diagnosed with a hydatidiform mole, and a metastatic workup was scheduled. Abdominal computed tomography showed a right ovarian vein thrombus. She received methotrexate chemotherapy combined with oral anticoagulants. Complete radiological remission was obtained. During the 12-month follow-up period, no disease progression or recurrence was noted. Early recognition and detection of the condition are of the utmost importance. The differential diagnosis of OVT must be considered when there is unexplained abdominal pain, fever, and leukocytosis during the diagnosis and treatment of GTN. A high level of suspicion is required for prompt diagnosis of OVT.

Keyword

Gestational trophoblastic neoplasia; Venous thrombosis; Anticoagulants

MeSH Terms

Abdominal Pain
Amenorrhea
Anticoagulants
Diagnosis
Diagnosis, Differential
Disease Progression
Drug Therapy
Female
Fever
Follow-Up Studies
Gestational Trophoblastic Disease*
Humans
Hydatidiform Mole
Leukocytosis
Methotrexate
Pregnancy
Rare Diseases
Recurrence
Thrombosis*
Veins*
Venous Thrombosis
Young Adult
Anticoagulants
Methotrexate

Figure

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  Fig. 1 Transvaginal ultrasound findings. The right adnexa showed multilobular and mixed echogenicity.

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  Fig. 2 Abdominal and pelvic contrast-enhanced computed tomography findings. (A) The multilobular and tortuous tubular hypodense mass with strong enhancing septae and peripheral wall in the right adnexa (arrow). (B) The right ovarian vein thrombus (arrow).

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