Feared complication of malignancy: Venous thromboembolism

INTRODUCTION: In this study we aimed to evaluate the relationship between the location and histological structure of primary malignancy and pulmonary thromboembolism (PTE) in patiens both having malignancy and pulmonary thromboembolism.
METHODS: Forty- two (42) patients followed by the diagnosis of both malignancy and PTE were enrolled in our study between May 2010- July 2013. We assessed our patients according to ages, genders, comorbidity and smoking habits and malignancy according to the location of malignancy, pathological subtypes, metastases and the duration of the initial diagnosis.
RESULTS: Of the whole 42 patients with malignancy and PTE, 15 patients were female (35,7%), 27 patients were male (64,3%). The mean age were 60,4 ± 14 (24-86). 19 patients (45,2%) were having pulmonary, 22 patiens (52,4%) were having extrapulmonary malignancy. The distrubition of pulmonary malignancy were as follows; adenocarcinoma (13 (30,9%)), squamous cell (4, (9,5%)) and small cell carcinoma (2 (4,7%)). The distrubition of extrapulmonary malignancy were as follows; gastrointestinal tract malignancies (9 (21,4%)), malignancy of the genitourinary system 8 (19%), head and neck tumors (3 (7,1%)), haematological malignancy (2 (7,1%)) and metastatic carcinoma of unknown primary (1(2,3%)). The lower extremity thrombosis in 25 patients (59,5%), the upper extremity thrombosis in 2 patients (4,8%), both upper and lower extremities thrombosis in 2 patients (4,8%) were detected by the examination of the venous Doppler ultrasound.
DISCUSSION AND CONCLUSION: Thromboembolic diseases are known as one of the major causes of mortality in cancer patients. It has been shown in the previously studies that pulmonary thromboembolism has an enhancing effect to mortality in cancer patients. Therefore, in the presence of clinical suspicion of PTE, it must be diagnosed and treated as soon as possible. Patients of whom are diagnosed as PTE should be reconsidered and further investigations should be performed because of the probability of an underlying malignancy.

Malignitelerin korkulan komplikasyonu: Venöz tromboembolizm

GÝRÝÞ ve AMAÇ: Malignite ve pulmoner tromboemboli birlikteliði tespit edilen hastalarda primer malignitenin yeri ve patolojik tipi ile pulmoner tromboemboli arasýndaki iliþkiyi incelemek amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Kliniðimizde Mayýs 2010-Ekim 2013 tarihleri arasýnda malignite ve pulmoner tromboemboli birlikteliði tespit edilen 42 hasta çalýþmaya alýndý. Bu olgularýn yaþ, cinsiyet, ek hastalýk, sigara alýþkanlýklarý sorgulandý. Primer malignitenin saptandýðý organ, patolojik tipi, metastaz varlýðý, taný zamaný, verilen tedaviler kaydedildi ve sonuçlar tartýþýldý.
BULGULAR: Çalýþmaya dahil edilen 42 malignite ve pulmoner tromboemboli tanýsý olan hastanýn 15’i kadýn (%35,7), 27’si erkekti (%64,3) ve yaþ ortalamalarý 60,4 ± 14 (24-86) olarak bulundu. 19 (%45,2) hastada primer akciðer malignitesi ve 23 (%54,7) hastada akciðer dýþý malignite mevcuttu. Akciðer malignitesi olan hastalarýn 13’ünde (%30,9) adenokarsinom, 4’ünde (%9,5) squamöz hücreli karsinom ve 2’sinde (%4,7) küçük hücreli karsinom saptandý. Akciðer dýþý malignitesi olanlarda, 9 hastada (%21,4) gastrointestinal sistem malignitesi, 8 hastada (%19) genitoüriner sistem malignitesi, 3 hastada (%7,1) baþ- boyun tümörü, 2 hastada (%7,1) hematolojik malignite ve 1 hastada (%2,3) primeri bilinmeyen metastatik karsinom tespit edildi. Yapýlan venöz Doppler ultrasonografi incelemesinde 25 hastada (%59,5) alt ekstremitede trombüs, 2 hastada (%4,8) üst ekstremitede trombüs, 2 hastada (%4,8) hem üst hem de alt ekstremitede trombüs tespit edildi.
TARTIÞMA ve SONUÇ: Kanser hastalarýnda tromboembolik hastalýklar önemli bir mortalite nedenidir. Özellikle pulmoner tromboembolinin mortaliteyi artýrýcý etkisi fazladýr. Bu nedenle klinik þüphe varlýðýnda PTE tanýsý bir an önce konulmalý ve tedavi edilmelidir. Bir baþka açýdan PTE nedeniyle takip edilen hastalarda altta yatan bir malignite olma olasýlýðý düþünülmeli ve gerekli incelemeler yapýlmalýdýr.