Recurrent Superior Vena Cava Syndrome in a Patient with Sarcoidosis and Pancreatic Adenocarcinoma: A Case Report and Literature Review.

Autor: Shenoy G; Penn State College of Medicine Medical Scientist Training Program, Hershey, PA 17033, USA., Kim Y; Penn State College of Medicine Medical Scientist Training Program, Hershey, PA 17033, USA., Newmaster K; Penn State College of Medicine Medical Scientist Training Program, Hershey, PA 17033, USA., McGillen KL; Department of Radiology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA., Ruggiero F; Department of Pathology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA., Yee NS; Division of Hematology-Oncology, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Next-Generation Therapies Program, Penn State Cancer Institute, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
Jazyk: angličtina
Zdroj: Medicines (Basel, Switzerland) [Medicines (Basel)] 2020 Sep 04; Vol. 7 (9). Date of Electronic Publication: 2020 Sep 04.
DOI: 10.3390/medicines7090056
Abstrakt: Background: Superior vena cava (SVC) syndrome may result from extravascular compression or intravascular obstruction such as thrombosis. Recurrent venous thrombosis is typically associated with a hypercoagulable state such as malignancy, and inheritable or acquired coagulopathy. Sarcoidosis is a derangement of the immune system, and it has been associated with malignant diseases and hypercoagulation. The association of pancreatic cancer and sarcoidosis with SVC syndrome has not been reported previously. Here, we present a case of recurrent venous thrombosis causing SVC syndrome in a patient with pancreatic ductal adenocarcinoma and underlying thoracic sarcoidosis. Methods: The patient's electronic health record was retrospectively analyzed. Results: A 66-year-old woman with pancreatic adenocarcinoma was treated with neoadjuvant chemotherapy followed by Whipple procedure, before developing tumor recurrence in the liver. Her treatment course was complicated with repeated incidents of venous thrombosis in the presence of a central venous catheter leading to recurrent SVC syndrome, which resolved with anti-coagulation. Conclusions: This case raises a plausible inter-relationship between sarcoidosis, pancreatic cancer, and hypercoagulable state. We suggest that patients with multiple risk factors for developing venous thrombosis should be carefully monitored for any thrombotic event, and they may benefit from prophylactic anti-coagulation.
Databáze: MEDLINE