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Clin Pract Cases Emerg Med 2022 May;6(2):141-145

HCA Healthcare/University of South Florida Morsani College of Medicine GME/Brandon Regional Hospital, Department of Emergency Medicine, Brandon, Florida.

Introduction: Postpartum ovarian vein thrombosis (POVT) is an uncommon diagnosis that may lead to morbidity or mortality if unrecognized.

Case Report: This report discusses a single case of POVT in a community hospital, along with the treatment and clinical course.

Conclusion: The mechanism is believed to be right-sided clot formation provoked by anatomical and hormonal changes of gestation. Read More

PLoS Med 2022 May 25;19(5):e1004012. Epub 2022 May 25.

Division of Hematology and Division of Hemostasis and Thrombosis, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America.

Background: Direct oral anticoagulants (DOACs) have comparable efficacy with low-molecular-weight heparin (LMWH) for the treatment of cancer-associated venous thromboembolism (VTE). Whether there is a mortality benefit of DOACs compared with warfarin in the management of VTE in cancer is not established.

Methods And Findings: Utilizing the United States' Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases from 2012 through 2016, we analyzed overall survival in individuals diagnosed with a primary gastric, colorectal, pancreas, lung, ovarian, or brain cancer and VTE who received a prescription of DOAC or warfarin within 30 days of VTE diagnosis. Read More

J Belg Soc Radiol 2022 27;106(1):24. Epub 2022 Apr 27.

Presbyterian Medical Center, KR.

Radiologists need to be familiar with that ovarian vein thrombosis can occur as a complication of urinary tract infection. Ovarian vein thrombosis is a rare disease in which a majority of cases occur during the postpartum period. There are few case reports for ovarian vein thrombosis associated with urinary tract infection in non-postpartum women. Read More

J Radiol Case Rep 2022 Apr 1;16(4):17-23. Epub 2022 Apr 1.

Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India.

Massive ovarian edema is an uncommon benign condition affecting young females predominantly those in the child bearing age group and preadolescent girls. Its clinical and radiologic overlap with ovarian neoplasms and torsion which require surgical intervention makes it imperative for the radiologist to consider this entity preoperatively as preserving fertility is vital in this young age group. We report a case of massive ovarian edema, a rare presentation in a patient with inferior vena cava web and consequent Budd Chiari Syndrome, an association previously unreported in literature. Read More

BMC Pregnancy Childbirth 2022 Apr 15;22(1):323. Epub 2022 Apr 15.

Department of Obstetrics and Gynecology, Shirakawa Kosei General Hospital, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima, 961-0005, Japan.

Background: Ovarian vein thrombosis (OVT) may cause maternal mortality by inducing pulmonary thromboembolism (PTE). However, the prevalence, etiology, risk factors, prognosis, and optimal treatments for asymptomatic OVT during and after pregnancies are unclear, which therefore requires a high clinical index of suspicion for certain diagnoses due to its vague presentation. We herein present a case of asymptomatic postpartum OVT that extended toward the inferior vena cava (IVC), resulting in a potential risk of PTE. Read More

Vasa 2022 May 13;51(3):182-189. Epub 2022 Apr 13.

Department of Angiology, University Hospital Zurich, Switzerland.

Treatment of pelvic venous disorders (PVD) including pelvic congestion syndrome (PCS) are often delayed due to its varying clinical manifestations. Patient referral was based on a literature- and personal experience-derived clinical "PCS screening score" (higher score points indicate greater likelihood with a maximum score of 10 points). We studied consecutive women who were (i) referred for vascular assessment and treatment to the University Hospital Zurich (2017-2021), (ii) had a PCS score ≥3 points, (iii) had evidence of obstructive or non-obstructive PVD by duplex sonography or cross-sectional imaging, and (iv) underwent endovascular therapy. Read More

Cureus 2022 Feb 22;14(2):e22504. Epub 2022 Feb 22.

Internal Medicine, National Hospital Organization Tochigi Medical Center, Utsunomiya, JPN.

Postpartum ovarian vein thrombosis (POVT) is an uncommon cause of postpartum fever. Because POVT is sometimes complicated by pulmonary embolism, preventing diagnostic delay is critical. Nonetheless, the diagnostic delay of POVT is common due to its rarity. Read More

BMJ Case Rep 2022 Mar 24;15(3). Epub 2022 Mar 24.

Department of Interventional Radiology, Christian Medical College and Hospital Vellore, Vellore, India.

A 50-year-old woman presented with progressive, painful and disabling swelling of the left lower limb following a left ovarian cyst excision 2 years ago. She had gross oedema of the left lower limb with multiple pubic varices. Contrast-enhanced CT and digital subtraction imaging revealed diffuse arteriovenous malformation (AVM) with feeders from the left internal iliac artery and a short segment significant stenosis of the proximal left common iliac vein. Read More

Cancers (Basel) 2022 Mar 15;14(6). Epub 2022 Mar 15.

Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.

Background: The incidence of venous thromboembolism (VTE) in patients with ovarian cancer is higher than most solid tumors, ranging between 10-30%, and a diagnosis of VTE in this patient population is associated with worse oncologic outcomes. The tumor-specific molecular factors that may lead to the development of VTE are not well understood.

Objectives: The aim of this study was to identify molecular features present in ovarian tumors of patients with VTE compared to those without. Read More

J Med Case Rep 2022 Mar 22;16(1):119. Epub 2022 Mar 22.

Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany.

Purpose: During the severe acute respiratory syndrome coronavirus 2 pandemic, several patient groups are at particular risk. Mortality is higher among cancer patients and may be increased further by thromboembolic events, which are more common in coronavirus 2019 patients according to recent publications. We discuss the association of gynecologic malignancies, Severe acute respiratory syndrome coronavirus 2, and thromboembolism by reporting a case study and summarizing available literature. Read More

Oncol Lett 2022 Apr 9;23(4):115. Epub 2022 Feb 9.

Oncology Department, Bioclinic Hospital, 54622 Thessaloniki, Greece.

Thromboprophylaxis, as a preventive measure for cancer-associated thrombosis (CAT), may be beneficial for patients with active cancer and high-risk for thrombosis. The present post hoc analysis include a total of 407 patients enrolled in the Greek Management of Thrombosis study, who received thromboprophylaxis with tinzaparin. The objectives of the present analysis were: i) To obtain sufficient evidence for the administration of prophylaxis in patients with active cancer, irrespective of Khorana risk assessment model score; ii) to identify the selection criteria for both dose and duration of tinzaparin; and iii) to evaluate the efficacy and safety of tinzaparin administered for CAT prophylaxis. Read More

Tidsskr Nor Laegeforen 2022 03 18;142(4). Epub 2022 Feb 18.

Clin Appl Thromb Hemost 2022 Jan-Dec;28:10760296221081121

Department of Medicine, Hematologic malignancies and cellular therapy, Duke University School of Medicine Durham, Durham, North Carolina, USA.

Context: The prevalence of venous thromboembolism (VTE) in patients with cancer is particularly high at disease progression and during relapse. Patients cared for in specialized palliative care units (SPCU) are rarely included in VTE studies. Objective: We sought to study the prevalence, clinical characteristics, and survival of individuals with VTE in an SPCU setting. Read More

Gynecol Oncol 2022 04 23;165(1):75-81. Epub 2022 Feb 23.

Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.

Objective: This study aimed to determine the incidence of thrombotic events in ovarian cancer patients following a de-escalated prophylactic strategy and to stratify risk groups.

Methods: We reviewed the records of patients who underwent debulking surgery for ovarian cancer at a single institution between January 2007 and May 2019. We identified clinically diagnosed and radiologically confirmed cases of thrombotic events-classified as pulmonary thromboembolism (PE), deep vein thrombosis (DVT), and other thrombotic events-within 6 months of debulking surgery. Read More

Ann Med Surg (Lond) 2022 Mar 9;75:103332. Epub 2022 Feb 9.

Urology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco.

Introduction: Obstructive Anuria (OA) constitutes a diagnostic and therapeutic emergency involving the vital prognosis of the patient requiring an emergency and multidisciplinary care. The etiologies are multiple and the pelvic gynecological cancers represent one of the main causes of OA.

Objectives: Describing the epidemiological, clinical, paraclinical, etiological, therapeutic and progressive aspects of obstructive anuria of the gynecological origin, in the urology department in the University Hospital Center. Read More

Cureus 2022 Jan 17;14(1):e21323. Epub 2022 Jan 17.

Cardiology, Al Jufairi Diagnosis and Treatment, Doha, QAT.

Gonadal vein thrombosis, also known as ovarian vein thrombosis, is a rare medical condition presenting mostly in the postpartum period. Gonadal vein thrombosis is associated with conditions such as inferior vena cava thrombosis, sepsis, and pulmonary emboli which can lead to high morbidity and mortality. This report illustrates the case of a 25-year-old female patient who presented to the emergency department with a history of abdominal pain for over three days. Read More

J Obstet Gynaecol Res 2022 Apr 17;48(4):1046-1049. Epub 2022 Feb 17.

Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi, Japan.

Ovarian vein thrombosis (OVT) usually occurs on the right side in women with underlying conditions such as pelvic diseases and thrombophilia or during the postpartum period. Here, we present a patient with bilateral OVTs without underlying conditions. A 63-year-old woman without remarkable past or family histories complained of mild lower abdominal pain. Read More

Radiol Case Rep 2022 Apr 4;17(4):1211-1214. Epub 2022 Feb 4.

Lehigh Valley Health Network, Department of Emergency and Hospital Medicine, Division of Ultrasound/ USF Morsani College of Medicine, Cedar Crest Boulevard & I-78, Allentown, PA, USA 18103.

Dyspnea is a common complaint in patients who present to the emergency department and can be due to numerous etiologies. This case report details a 90-year-old female with a history significant for hypertension, hyperlipidemia, and new diagnosis of ovarian malignancy whose symptoms increased over the past three days. Point-of-care Ultrasonography showed multiple B-lines, a plethoric IVC without respiratory variation, a markedly low EF and a lack of RV dilation. Read More

J Obstet Gynaecol Res 2022 Apr 2;48(4):1050-1054. Epub 2022 Feb 2.

Gynecology Service, National Hospital Organization Kyushu Cancer Center, Fukuoka City, Fukuoka, Japan.

We report the case of a large pelvic lymphocele after an ovarian cancer operation, which incidentally vanished after bleeding resulting from percutaneous catheter drainage. The patient was a 74-year-old woman with stage IVB ovarian cancer who underwent surgery including pelvic lymph node dissection. Three months after surgery, computed tomography revealed a large (13-cm diameter) pelvic lymphocele with associated bilateral hydronephrosis and left femoral vein thrombosis. Read More

JRSM Open 2022 Jan 24;13(1):20542704221074150. Epub 2022 Jan 24.

Franciscus Gasthuis & Vlietland, Department of Gynecology & Obstetrics, Rotterdam, Netherlands.

Idiopathic left ovarian vein thrombosis was diagnosed in a 27-year-old woman at the time of a diagnostic laparoscopy performed because of a suspected ovarian torsion. The diagnosis was confirmed by abdominal computed tomography scanning. Subsequent magnetic resonance imaging showed no signs of an abdominal or pelvic mass nor enlarged lymph nodes. Read More

J Obstet Gynaecol Res 2022 Mar 24;48(3):817-823. Epub 2022 Jan 24.

Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

Aim: Cell-free and concentrated ascites reinfusion therapy (CART) is useful for treating malignant ascites. We have previously experienced cases with no DVT-PE despite a marked elevation in D-dimer post-CART. In this study, we assessed the changes in the D-dimer levels in patients who received CART and investigated the association between elevated D-dimer levels and occurrence of DVT-PE. Read More

BMJ Case Rep 2021 Dec 30;14(12). Epub 2021 Dec 30.

Gynaecology and Obstetrics, Centro Hospitalar de Entre o Douro e Vouga EPE, Santa Maria da Feira, Aveiro, Portugal.

A healthy 38-year-old woman, with no significant medical or surgical history, was referred to the gynaecology emergency department with acute low quadrant abdominal pain and nausea. On examination, painful palpation of right iliac fossa, abdominal guarding and positive Blumberg's sign were noted. An abdominal-pelvic CT scan showed a hypodense tubular structure with peripheral enhancement to the right of the inferior vena cava, suggestive of thrombosis of the right ovarian vein. Read More

BMC Surg 2021 Dec 28;21(1):443. Epub 2021 Dec 28.

Department of Urology, Peking University Third Hospital, 49 North Garden Road, Haidian, Beijing, 100191, People's Republic of China.

Purpose: To explore the effect of tumor thrombus growing against the direction of venous return (GADVR) tumor thrombus on the choice of surgical approach, the impact on the complexity of the surgery and the prognosis.

Methods: We retrospectively analyzed the clinicopathological data of 213 patients, who underwent surgery in a single center of Peking University Third Hospital between January 2016 and June 2020. For right renal cell carcinoma (RCC) and venous tumor thrombus (VTT), imaging revealed a filling defect in the left renal vein, which was significantly enhanced in enhanced imaging, suggesting that the tumor thrombus grew against the direction of venous return into the left renal vein. Read More

Gynecol Oncol 2022 02 16;164(2):311-317. Epub 2021 Dec 16.

Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada; Gynecologic Oncology, University Health Network, Toronto, ON, Canada. Electronic address:

Objective: To determine the 30-day incidence of venous thromboembolism (VTE) after gynecologic oncologic surgery and identify perioperative factors associated with postoperative VTE.

Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried to identify all gynecologic oncology cases from 2013 to 2019. Clinical and surgical characteristics, VTE events and 30-day postoperative complications were retrieved. Read More

Proc (Bayl Univ Med Cent) 2021 29;34(6):705-707. Epub 2021 Jun 29.

Department of Hematology and Oncology, Louisiana State University Health Sciences Center, Shreveport, Louisiana.

COVID-19 (coronavirus disease-19) is associated with an increased risk for thrombosis due to endothelial dysfunction and hyperactivation of the immune system induced by the virus. Most cases of venous thromboembolism associated with COVID-19 are either pulmonary emboli or deep vein thromboses. Ovarian vein thrombosis is a rare condition most commonly seen in the postpartum period. Read More

J Med Case Rep 2021 Oct 25;15(1):521. Epub 2021 Oct 25.

York Teaching Hospital, NHS Foundation Trust, Scarborough, UK.

Background: Postpartum ovarian thrombosis is an uncommon condition. It appears with the nonspecific, predominantly right-sided abdominal symptoms and must be differentiated from other acute visceral conditions. If left untreated, postpartum ovarian thrombosis can have severe consequences, including sepsis, pulmonary embolism, and even death. Read More

Blood Adv 2022 01;6(1):307-320

Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology Oncology, University of California Davis School of Medicine, Sacramento, CA; and.

Cancer-associated thrombosis (CAT) is an important cause of morbidity and mortality for patients with malignancy and varies by primary cancer type, stage, and therapy. We aimed to characterize the incidence, risk factors, temporal trends, and the effect on mortality of CAT. The California Cancer Registry was linked to the statewide hospitalization database to identify individuals with the 13 most common malignancies diagnosed between 2005 and 2017 and determine the 6- and 12-month cumulative incidence of CAT by venous thromboembolism (VTE) location, tumor type, and stage after adjusting for competing risk of death. Read More

J Thromb Haemost 2022 01 15;20(1):104-114. Epub 2021 Oct 15.

Section of Benign Hematology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Background: Podoplanin (PDPN) is a sialylated membrane glycoprotein that binds to C-type lectin-like receptor 2 on platelets resulting in platelet activation. PDPN is expressed on lymphatic endothelial cells, perivascular fibroblasts/pericytes, cancer cells, cancer-associated fibroblasts, and tumor stromal cells. PDPN's expression on malignant epithelial cells plays a role in metastasis. Read More

Cancers (Basel) 2021 Sep 14;13(18). Epub 2021 Sep 14.

Department Medical Oncology, Ghent University Hospital, 9000 Ghent, Belgium.

Thromboembolic events are the second cause of death in cancer patients. In ovarian cancer, 3-10% of patients present with venous thromboembolism (VTE), but the incidence may rise to 36% along the disease course. Bevacizumab is a monoclonal antibody directed against vascular endothelial-derived growth factor, and in in vitro studies it showed a predisposition to hemostasis perturbation, including thrombosis. Read More

Case Rep Obstet Gynecol 2021 8;2021:6389713. Epub 2021 Sep 8.

Department of Obstetrics and Gynecology, St George University Medical Center, Beirut, Lebanon.

Ovarian vein thrombophlebitis is rare and mostly occurs during the puerperal period and in higher rates after a cesarean delivery. The objective of this case report and literature review is to highlight the rare occurrence of an ovarian vein thrombosis in a 37-year-old woman postcesarean delivery in the setting of a large uterine fibroid who subsequently developed a pulmonary embolism. The patient presented with severe abdominal pain, fever, and chills. Read More