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Venous thromboembolism (VTE) affects upto 15% of all cancer patients. Mortality is increased in patients who have coexisting VTE with metastatic malignant disease, making it the second leading cause of death in these patients. The recommended management is primary debulking surgery with placement of inferior vena cava filter (IVCF) to prevent life threatening pulmonary embolism. This study presents a case of 66 years old lady, P4+2, known case of hypertension and asthma, developed acute swelling of right leg which was diagnosed as deep vein thrombosis (DVT) on colour Doppler ultrasound. A pelvic mass was suspected which later on revealed a huge heterogenous density adnexal mass on abdominopelvic ultrasound. CA -125 was 7522.3 U/ml. Ultrasound guided trucut biopsy of the pelvic mass revealed low grade serous papillary ovarian carcinoma. IVC filter could not be placed as the venogram showed complete thrombosis in the right common iliac vein as well as portal thrombus in the infrarenal IVC. Primary debulking surgery without placement of IVCF was done. Postoperative period was uneventful and patient was referred for chemotherapy. To conclude, malignancy should be suspected in patients whose initial presentation is venous thromboembolism. Primary debulking surgery without placement of inferior vena cava filter can be considered a feasible management option in patients of ovarian cancer with VTE who cannot get IVCF placement.
Maria Habib, Irum Sohail. (2020) Venous Thromboembolism as Initial Presentation of Ovarian Malignancy and Primary Debulking Surgery Without Placement of Inferior Vena Cava Filter: A Case Report, Journal of the Society of Obstetrics and Gynaecologists of Pakistan , Volume-10, Issue-2.
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