If no triggering event can be identified for a patient with deep vein thrombosis, an unknown cancer should be considered as a cause. Rosemary Poulose and L. Christian Napp, MD, et al from Hannover Medical School in Germany recalled this in a recent journal article. They recounted the medical history of a 72-year-old woman.
The Patient’s History
The woman had been treated on an inpatient basis for 3 months for paranoid schizophrenia. The authors reported that the patient had refused subcutaneous thrombosis prophylaxis, which was indicated because of insufficient mobility. Three months after being admitted to the clinic, she complained of sudden-onset pain and swelling of the right leg.
Swelling of the entire right lower leg and foot, which transitioned into a hard, nonmoveable, space-occupying mass dorsal to the knee
Intact peripheral perfusion, motor function, and sensory function
Movement of the right knee slightly impaired
Payr test and Meyer sign negative
Laboratory tests: elevated D-dimer (1.58 mg/L; n