Ayako Ro1,2, Norimasa Kageyama1,2, Toshiji Mukai1. 1. Department of Legal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan. 2. Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo, Japan.
Abstract
Objective: This study aimed to determine the clinicopathological characteristics of cancer-associated venous thromboembolism (CAT-VTE). Methods: A total of 47 cases of lethal pulmonary thromboembolism (PTE) with active cancer were investigated by autopsy records. Results: We studied 22 men and 25 women who were deceased at a mean age of 66±11 years. Nine (19%) patients had recently undergone cancer resection, 14 (30%) were undergoing clinical treatment for cancer, and 24 (51%) were autopsy-proven CAT-VTE. The colon (eight cases), lungs (seven cases), and ovaries (six cases) were frequent sites of a tumor. There were 29 (62%) cases of acute PTE and 18 (38%) of recurrent PTE. The embolic source was detected in 36/39 (92%) cases. Among them, 33 cases were leg deep vein thrombosis (DVT) and 31 were calf-type DVT. Three cases were isolated vena cava thrombi that were present near the tumor. Twenty-three (64%) cases were recurrent DVT. Conclusion: Most of the lethal CAT-VTE cases were induced by the same mechanism as non-CAT-VTE that originated from calf-type DVT with proximal propagation. However, the finding that patients had tumor-related vena cava thrombi suggested that prevention of CAT-VTE requires individualized treatment of patients according to their pathological condition. (This is secondary publication from Jpn J Phlebol 2020; 31(3): 123-129.).
Objective: This study aimed to determine the clinicopathological characteristics of cancer-associated venous thromboembolism (CAT-VTE). Methods: A total of 47 cases of lethal pulmonary thromboembolism (PTE) with active cancer were investigated by autopsy records. Results: We studied 22 men and 25 women who were deceased at a mean age of 66±11 years. Nine (19%) patients had recently undergone cancer resection, 14 (30%) were undergoing clinical treatment for cancer, and 24 (51%) were autopsy-proven CAT-VTE. The colon (eight cases), lungs (seven cases), and ovaries (six cases) were frequent sites of a tumor. There were 29 (62%) cases of acute PTE and 18 (38%) of recurrent PTE. The embolic source was detected in 36/39 (92%) cases. Among them, 33 cases were leg deep vein thrombosis (DVT) and 31 were calf-type DVT. Three cases were isolated vena cava thrombi that were present near the tumor. Twenty-three (64%) cases were recurrent DVT. Conclusion: Most of the lethal CAT-VTE cases were induced by the same mechanism as non-CAT-VTE that originated from calf-type DVT with proximal propagation. However, the finding that patients had tumor-related vena cava thrombi suggested that prevention of CAT-VTE requires individualized treatment of patients according to their pathological condition. (This is secondary publication from Jpn J Phlebol 2020; 31(3): 123-129.).