1.
[Thromboembolic event and metabolic hyperhomocysteinemia: A case report and review of literature].
Biron, F, Rousseau, JF, Baulin, JM, Guérin-Boyer, M, Lanéelle, D
Annales de cardiologie et d'angeiologie. 2021;(3):177-182
Abstract
INTRODUCTION Venous thromboembolic diseases have an incidence of 1.57/1000. Among patients under 50 years old, thrombophilia is assessed, the indications for which are increasingly stringent. Today, the need of plasma homocysteine assay is uncertain. OBSERVATION Our case is a 42 year-old man, in whom a pulmonary embolism associated with macrocytosis made us discover a B12 deficiency secondary to Biermer's disease. In the literature, patients are men with an average age limit to the realisation of the assessment of thrombophilia. Not all of these patients had any causal other than hyperhomocysteinemia secondary to Biermer's disease. The support is not detailed. CONCLUSION Hyperhomocysteinemia is probably not the only thromboembolic factor. The patient received anticoagulation and vitamin B12 supplementation. A good reading of the complete blood count is essential.
2.
[Five-Year Recurrence-Free Survival after mFOLFOX6 Administration, Right Hemicolectomy, and Lymphadenectomy for Portal Venous Tumor Thromboembolism].
Nishimura, Y, Nishizawa, Y, Ishikawa, H, Mori, Y, Takano, M, Takenoya, T, Asayama, M, Kawashima, Y, Sakamoto, H, Tanaka, Y
Gan to kagaku ryoho. Cancer & chemotherapy. 2015;(12):1653-5
Abstract
A 71-year-old woman was admitted for fever and appetite loss. She was diagnosed with ascending colon cancer, with portal vein tumor thromboembolism extending to the portosplenic junction. This was deemed unresectable despite the absence of distant metastasis. She underwent 16 courses of mFOLFOX6 therapy, and because the effect of chemotherapy was PR, right hemicolectomy with high ligation of the ileocolic vessels and the right branch of the middle colic vessels was performed. The tumor stage was yp-T3N1bM0, StageⅢB with a few remaining cancer cells in the portal venous system. Staging after chemotherapy effect was Grade 1a. Postoperatively, 13 courses of mFOLFOX6 were administered. A repeat CT scan showed lymph node recurrence along the SMV, which was subsequently resected again. After the second operation, 9 courses of the DeGramont regimen was administered and discontinued. Five years after the last operation, the patient remains well and without any recurrences. Colonic carcinoma with portal venous tumor thromboembolism has been reported in 9 cases, including ours. Among these, 8 cases involved the ascending colon. Seven of the affected patients were female while 3 were poorly differentiated adenocarcinoma. None of the other patients, except for our case, reported a 5 year patient survival rate without recurrence.