Abstract
It's well known that thromboembolic disease can occur concurrently with a malignancy, often it also can precede tumor even a number of months earlier. For this reason, when venous thrombosis or pulmonary embolism is detected, examinations to exclude concomitant neoplasia are often indicated.
There are different opinions on the benefits of routine oncological screening. However, there are situations where a more detailed examination should be done.
One of these is the case of recurrent thromboembolic events within a short period of time, despite effective anticoagulant therapy. The authors present two case reports.
The first case is 59-years old man who had been examined for recurrent superficial and deep vein thrombosis and pulmonary embolism despite effective treatment with warfarin (coumarin anticoagulant). The health condition was then complicated by recurrent myocardial ischemia (STEMI of the diaphragmatic wall) on the basis of thrombotic occlusion of the coronary artery.
In pursuance of the next diagnostics the nodal syndrom was detected. A hematological malignancy was considered at the beginning, finally the lung tumor with metastases to the nodes, brain, cerebellum and skeleton was confirmed.
The patient's condition quickly progressed and he died. The second patient was 46-years old woman with recurrent venous thrombosis despite effective anticoagulant therapy.
Subsequently a lung tumor with metastases to the nodes and skeleton was proven. Shortly after diagnosis, the woman died of massive pulmonary embolism, although according to laboratpry tests she had been adequately treated.