Subject(s)
Anticoagulants/therapeutic use , Vitamin K/antagonists & inhibitors , Aged , Anticoagulants/adverse effects , Female , Hemorrhage/chemically induced , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Incidence , Male , Middle Aged , Prospective Studies , Registries , Thromboembolism/drug therapy , Thromboembolism/epidemiology , Thromboembolism/prevention & controlABSTRACT
HISTORY: A 65-year-old man had noted a tumor of the right lower leg that had progressively grown over the last twenty years. He had a dyspnoea on insignificant movement and was relatively immobile because of the extent of the tumor. The tumor had been diagnosed as a Klippel-Trenaunay syndrome. INVESTIGATIONS: Laboratory investigations suggested a hypochromic and microcytic anaemia and an inflammatory constellation. The tumor had no av-fistulas on ultrasonography and angiography, but there were many pathological arteries and tumor nodes. The tumor nodes had been seen also on MRI-biopsy suggested a neurogenic sarcoma. DIAGNOSIS AND TREATMENT: Amputation of the leg was necessary. The histological diagnosis was neurofibrosarcoma with extensive necrotic areas and Recklinghausen disease. Investigation did not reveal any metastasis. Postoperatively the anaemia regressed and the patient learned to walk with a prosthesis. CONCLUSIONS: This history shows the problem of separating clearly the two hereditary diseases. Often there is a different clinical picture in everyday life. One must consider the definitely higher risk of malignant tumors of patients with neurofibromatosis. Ultrasonography is a non-invasive method that can provide morphological information on soft parts and pathology of the vessels. It facilitates the classification of such.
Subject(s)
Neurofibromatosis 1/complications , Neurofibrosarcoma/complications , Aged , Amputation, Surgical , Artificial Limbs , Diagnosis, Differential , Humans , Klippel-Trenaunay-Weber Syndrome/diagnosis , Leg/surgery , Male , Neurofibromatosis 1/diagnostic imaging , Neurofibromatosis 1/pathology , Neurofibromatosis 1/surgery , Neurofibrosarcoma/diagnostic imaging , Neurofibrosarcoma/pathology , Neurofibrosarcoma/surgery , Treatment Outcome , UltrasonographyABSTRACT
The risk of venous thromboembolism associated with long-haul flights is the subject of controversy. In a prospective, controlled study, we examined 160 passengers before and after return from a long-haul flight and 160 age-matched and sex-matched, non-travelling volunteers using venous compression ultrasound. Deep vein thrombosis was not observed in either group. Isolated calf muscle vein thrombosis (ICMVT) was present in 4/160 (2.5%) flight passengers and in 1/160 (0.6%) controls. All subjects with ICMVT were clinically asymptomatic, and ICMVT was located in the soleal muscle veins in all four subjects. Three of the four passengers with ICMVT had other risk factors for thrombosis.
