Rare Distal Metastasis of Endometrial Adenocarcinoma Impersonating as Primary Colon Cancer

An 89-year-old Caucasian female with a recent diagnosis of endometrial adenocarcinoma status post hysterectomy and acute deep vein thrombosis on anticoagulation presented with hematochezia. Colonoscopy revealed sigmoid colon stricture with the biopsy findings of metastatic endometrial adenocarcinoma based on positive immunohistochemistry staining for cytokeratin 7, paired box gene 8, and estrogen receptor. The oncologist referral was given to the patient for consideration of chemotherapy, but she decided to go with palliative care. Thus far, only 2 similar cases have been published in the literature. Our case exemplifies the potential for an unconventional pattern of metastasis of primary endometrial adenocarcinoma to the colon.

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Acute Deep Vein Thrombosis Treated with Porcine Plasmin

Thrombosis and Haemostasis ◽

10.1055/s-0038-1647715 ◽

1974 ◽

Vol 32 (02/03) ◽

pp. 468-482 ◽

Cited By ~ 2

Author(s):

O Storm ◽

P Ollendorff ◽

E Drewsen ◽

P Tang

Keyword(s):

Deep Vein Thrombosis ◽

Lower Limb ◽

Initial Dose ◽

Treated Group ◽

Allergic Reactions ◽

Double Blind ◽

Vein Thrombosis ◽

Thrombolytic Effect ◽

Acute Deep Vein Thrombosis ◽

Deep Vein

SummaryThe thrombolytic effect of pig plasmin was tested in a double blind trial on patients with deep venous thrombosis in the lower limb. Only patients with not more than three days old thrombi were selected for this study. The diagnosis of deep vein thrombosis was made clinically and confirmed by phlebography. Lysofibrin Novo (porcine plasmin) or placebo (porcine plasminogen) was administered intravenously to the patients. The enzyme and the placebo were delivered as lyophilized powder in labelled bottles - the contents of the bottles were unknown to the doctor in charge of the clinical administration of the trial. An initial dose of plasmin/plasminogen of 30 unit per kg body weight given slowly intravenously (1-1% hours infusion) was followed by a maintenance dosis of 15 per cent the initial dose per hour for the following 5-7 hours. In most cases a similar maintenance dosis was given the next day. In all patients heparin was administered after ending the plasmin/plasminogen infusion. The results of the treatment was evaluated clinically as well as by control phlebo- grams the following days.A statistically significant improvement was found in the plasmin treated group compared with the placebo (plasminogen) treated group. Thrombolysis was obtained clinically and phlebographically in 65 per cent of the plasmin treated group, but only in 15 per cent of the control patients were improvements found.This study has thus demonstrated that plasmin treatment according to a standard scheme was able to induce thrombolysis. There were only a few and insignificant side effects. Allergic reactions have not been seen and only very simple tests are required.

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Subcutaneous Recombinant Hirudin (HBW 023) Versus Intravenous Sodium Heparin in Treatment of Established Acute Deep Vein Thrombosis of the Legs: a Multicentre Prospective Dose-ranging Randomized Trial

Thrombosis and Haemostasis ◽

10.1055/s-0038-1656063 ◽

1997 ◽

Vol 77 (05) ◽

pp. 0834-0838 ◽

Cited By ~ 59

Author(s):

François Schiele ◽

Folke Lindgaerde ◽

Henry Eriksson ◽

Jean-Pierre Bassand ◽

Anders Wallmark ◽

...

Keyword(s):

Bleeding Complications ◽

Recombinant Hirudin ◽

Serious Adverse Events ◽

Sodium Heparin ◽

Efficacy Analysis ◽

Vein Thrombosis ◽

Dose Ranging ◽

Acute Deep Vein Thrombosis ◽

Deep Vein ◽

Intravenous Sodium

SummaryThe aim of this multicentre, prospective, randomised, dose-ranging study was to compare the safety and efficacy of subcutaneous recombinant hirudin (HBW 023) against intravenous sodium heparin in acute lower limb deep venous thrombosis (DVT). Patients were randomized to treatment with either HBW 023 or heparin for 5 ±1 days. HBW 023 was given according to body-weight in three dose groups. Thromboembolic disease was assessed by phlebography and ventilation/perfusion (V/Q) scanning on Bay 1 and Day 5±1. One hundred and fifty-five patients were enrolled, of these 121 were evaluable for efficacy analysis. Significantly fewer patients on HBW 023 developed new V/Q abnormalities during the treatment period, (p = 0.006). There was no difference between the groups in thrombus extension or regression, major bleeding complications or serious adverse events. There were significantly fewer findings of new V/Q mismatch after treatment with HBW 023, and anticoagulant control was superior in these patients.

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Bed Rest or Ambulation in the Initial Treatment of Patients With Acute Deep Vein Thrombosis or Pulmonary Embolism: Findings From the RIETE Registry

Yearbook of Vascular Surgery ◽

10.1016/s0749-4041(08)70604-3 ◽

2007 ◽

Vol 2007 ◽

pp. 348-349

Author(s):

G.L. Moneta

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Initial Treatment ◽

Bed Rest ◽

Vein Thrombosis ◽

Acute Deep Vein Thrombosis ◽

Deep Vein

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Clinical efficacy of one-stage thrombus removal via contralateral femoral and ipsilateral tibial venous access for pharmacomechanical thrombectomy in entire-limb acute deep vein thrombosis: A retrospective cohort study

Journal of Vascular Surgery Venous and Lymphatic Disorders ◽

10.1016/j.jvsv.2021.01.007 ◽

2021 ◽

Author(s):

Qihong Ni ◽

Jianyun Long ◽

Xiangjiang Guo ◽

Shuofei Yang ◽

Xiaohu Meng ◽

...

Keyword(s):

Cohort Study ◽

Deep Vein Thrombosis ◽

Clinical Efficacy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Venous Access ◽

Vein Thrombosis ◽

Thrombus Removal ◽

Acute Deep Vein Thrombosis ◽

Deep Vein

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Thrombolytic strategies versus standard anticoagulation for acute deep vein thrombosis of the lower limb

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd002783.pub5 ◽

2021 ◽

Author(s):

Cathryn Broderick ◽

Lorna Watson ◽

Matthew P Armon

Keyword(s):

Deep Vein Thrombosis ◽

Lower Limb ◽

Vein Thrombosis ◽

Acute Deep Vein Thrombosis ◽

Deep Vein

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The Predictive Value of the aCL and Anti-β2GPI at the Time of Acute Deep Vein Thrombosis—A Two-Year Prospective Study

Biomedicines ◽

10.3390/biomedicines9080901 ◽

2021 ◽

Vol 9 (8) ◽

pp. 901

Author(s):

Katja Perdan-Pirkmajer ◽

Polona Žigon ◽

Anja Boc ◽

Eva Podovšovnik ◽

Saša Čučnik ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Prospective Study ◽

Anticoagulant Therapy ◽

Predictive Value ◽

Anticoagulation Therapy ◽

Time Frame ◽

Vein Thrombosis ◽

Therapeutic Decisions ◽

Acute Deep Vein Thrombosis ◽

Deep Vein

Antiphospholipid syndrome (APS) is an important cause of deep vein thrombosis (DVT). According to current APS classification criteria, APS cannot be confirmed until 24 weeks after DVT. This time frame results in frequent discontinuation of anticoagulant treatment before APS is diagnosed. Therefore, the aim of our study was to evaluate the potential predictive value of anticardiolipin (aCL) and anti-β2glycoprotein I (anti-β2GPI) before discontinuation of anticoagulation therapy. Patients with newly diagnosed DVT were included into a 24-month prospective study. All patients received anticoagulant therapy. aCL and anti-β2GPI were determined at inclusion and every four weeks for the first 24 weeks and then one and two years after inclusion. APS was confirmed in 24/221 (10.9%) patients. At the time of acute DVT 20/24 (83.3%), APS patients had positive aCL and/or anti-β2GPI. Two patients had low aCL levels and two were negative at the time of acute DVT but later met APS criteria due to lupus anticoagulant (LA). Our data indicate that negative aCL and/or anti-β2GPI at the time of acute DVT make further aPL testing unnecessary; however, LA should be determined after discontinuation of anticoagulant therapy. Positive aCL and/or anti-β2GPI at the time of acute DVT have a strong positive predictive value for APS and may support therapeutic decisions.

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