Pulmoner Emboli Tarafından Saklanan Sır: Kolon Adenokarsinomu
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Kanser ve pulmoner emboli birlikteliği ve aralarındaki ilişki
iyi bilinmesine rağmen, kanser taraması klinik pratikte rutin olarak yapılmamaktadır.
Ancak, pulmoner emboli tanısıyla gelen olgularda malignite araştırılması bazı
hastalar için hayat kurtarıcı değerde olabilmektedir. Pulmoner emboli ve
idiyopatik venöz tromboemboli (VTE) tanısı alan ve pıhtılaşma eğilimi yönünden
risk faktörü bulunmayan 53 yaşındaki kadın hastayı sunduk. İdiyopatik VTE
nedenlerini özellikle altta yatan olası bir kanseri saptayabilmek için klinik
ve laboratuvar araştırmaları yapıldı. Sonuç olarak, çekum tümörü abdomen
manyetik rezonans görüntüleme (MRG) ve abdomen bilgisayarlı tomografi (BT)
kullanılarak gösterildi. Patoloji sonucu erken evre kolon adenokarsinomu olarak
raporlandı. Genel cerrahi kliniği tarafından sağ hemikolektomi uygulandı ve
hastaneden sorunsuz bir şekilde taburcu edildi. İdiyopatik VTE ile ilişkili
altta yatan gizli kanser yönünden araştırılma konusunda net bir fikir birliği
bulunmamasına rağmen, açıklanamayan pıhtılaşma eğiliminin olduğu olgularda
gizli bir kanser açısından değerlendirme yapılmalıdır.
The Mystery Hidden by Pulmonary Embolism: Colonic Adenocarcinoma
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Despite
the fact that the association between cancer and pulmonary embolism is well
recognised, screening for malignancy is not conducted routinely. However,
screening for malignancy can be life-saving for some patients. We present the
case of a 53-year-old woman who was diagnosed with pulmonary embolism and
concomitant idiopathic venous thromboembolism (VTE) without any prominent risk
factors for a hypercoagulative state. Clinical and laboratory tests were used
to detect the potential causes of idiopathic VTE, such as occult cancer.
Consequently, abdominal magnetic resonance imaging and computed tomography
revealed caecal tumour. Pathological test results indicated early-stage colonic
adenocarcinoma. Right hemicolectomy was performed by general surgery and the
patient was discharged from the hospital without any problems. Although there
has been no consensus about screening for an occult malignancy routinely in
idiopathic VTE, occult cancer should be considered in unexplained
hypercoagulative states.
___
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