Perioperative management of a patient with deep vein thrombosis caused by estrogen producing granulosa cell tumor of the ovary

Naoko Nakaigawa, Ryu Komatsu, Keiko Hamada, Kotoe Kamata, Makoto Ozaki

Research output: Contribution to journalArticlepeer-review

Abstract

We experienced perioperative management of a woman with large thrombi in femoral veins caused by estrogen producing ovarian tumor. At presentation, serum estradiol level was extremely high. Time constraint due to rapid expansion of the tumor did not allow us a trial of preoperative anti-coagulation. We placed a temporary IVC filter and proceeded with operation. As catastrophic pulmonary embolism could occur even with the presence of a filter, we prepared for institution of cardiopulmonary bypsss and pulmonary embolectomy via full sternotomy. We monitored arterial pressure based-cardiac output for immediate detection of pulmonary embolism. Postoperatively, serum estradiol level declined to normal range by post-operative day 7, and thrombi dissolved with anticoagulation therapy with warfarin and heparin without recurrence. In this case, surgery without preoperative anticoagulation was considered to pose extreme risk of perioperative pulmonary embolism. However, we considered that the thrombi would disolve by the removal of the tumor because estradiol production was the primary cause of thrombi. With above mentioned perioperative approach, the patient was managed uneventfully.

Original languageEnglish
Pages (from-to)224-227
Number of pages4
JournalJapanese Journal of Anesthesiology
Volume59
Issue number2
Publication statusPublished - 2010 Feb 1
Externally publishedYes

Keywords

  • Deep vein thrombosis
  • Estrogen producing tumor
  • Giant tumor of the ovary
  • IVC filter

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Fingerprint Dive into the research topics of 'Perioperative management of a patient with deep vein thrombosis caused by estrogen producing granulosa cell tumor of the ovary'. Together they form a unique fingerprint.

Cite this