ABSTRACT
Intravascular tumour extension can occur in many different types of cancer. Those with the highest tendency include renal cell carcinoma, adrenal cortical carcinoma and hepatocellular carcinoma. Inferior vena cava (IVC) tumour thrombus in gynaecological malignancy is rarely reported. We present a report on a female patient with extensive IVC tumour thrombus (intravenous leiomyomatosis) with concurrent intrauterine leiomyomatosis. She underwent a single-stage procedure, involving laparotomy and a sternotomy to remove her pelvic tumour, as well as the intracaval and intracardiac thrombus. The clinical presentation and management of this rare tumour will be detailed in this case report.
Subject(s)
Carcinoma, Renal Cell , Kidney Neoplasms , Leiomyomatosis , Liver Neoplasms , Thrombosis , Vascular Diseases , Venous Thrombosis , Carcinoma, Renal Cell/pathology , Female , Humans , Kidney Neoplasms/pathology , Leiomyomatosis/diagnostic imaging , Leiomyomatosis/pathology , Leiomyomatosis/surgery , Liver Neoplasms/pathology , Thrombosis/pathology , Vascular Diseases/pathology , Vena Cava, Inferior/diagnostic imaging , Vena Cava, Inferior/pathology , Vena Cava, Inferior/surgery , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/etiology , Venous Thrombosis/surgeryABSTRACT
OBJECTIVE: To determine the effect of intermittent pneumatic foot and calf compression on popliteal artery mean systolic blood flow in patients with intermittent claudication. The secondary objective was to determine the change in blood flow with posture. METHODS: This was a cross sectional study carried out on claudication patients at the Vascular Laboratory, Department of General Surgery, Kuala Lumpur Hospital, from January 2009 to August 2009. The effect of posture (supine to sitting to standing) and the effect of intermittent pneumatic compression (IPC) of the foot and calf on popliteal artery flow immediately and 10 minutes post compression were studied. RESULTS: Fifteen patients were studied. There was a consistent drop in flow from supine to sitting and to standing in all patients. Immediately after IPC application there was an increase in flow ranging from 29-335% (p<0.05). Increase in flow was reduced but still sustained after 10 minutes with a flow range of 17-113mL/minute with a median of 63mL/minute (p<0.05). CONCLUSION: There is a significant reduction in popliteal artery mean systolic flow from supine to sitting and to the standing position, and popliteal artery flow is significantly increased after application of IPC and even persists after 10 minutes.
