The analysis of deep vein thrombosis in women with ovarian tumors before surgery

Abstract

This study was conducted to establish the strategy for diagnosis of deep vein thrombosis (DVT)in women with ovarian tumors before surgery in Kobe University Hospital. Medical charts of 193 women with ovarian tumors who had undergone surgery in Kobe University Hospital between January 2006 and June 2010 were systemically reviewed. Pathological examinations identified 115 cases with benign ovarian tumors, 15 cases with borderline malignancy and 63 cases with malignant ovarian tumors. Clinical and laboratory data were compared between patients diagnosed as having DVT and those with no evidence of DVT. Venous ultrasound imaging of the lower extremity was performed in 32 out of 193 patients. 18 out of 32 patients were diagnosed as having DVT before surgery, including 5 cases with benign ovarian tumors, 2 cases with borderline malignancy, and 11 cases with malignant ovarian tumors. The statistical analyses were performed between DVT patients and non-DVT patients in terms of benign-malignancy, ages, with or without symptoms, tumor maximum diameters, plasma D-dimer levels and BMI. The incidence of DVT was significantly higher in patients with malignant ovarian tumors compared with those with benign ovarian tumors. The incidence of DVT was not correlated with ages. The symptom such as limb pains, edema in the lower extremity clearly indicated the DVT existence compared with no symptom. The tumor maximum diameters had no significant differences in between DVT patients and non-DVT patients. But plasma D-dimer levels were significantly higher in patients with DVT than in those without DVT. Plasma D-dimer levels were found to be more than 3.0 μg/ml in all 18 cases with DVT. 12 out of 18 cases with DVT had symptoms. However, venous ultrasound imaging of the lower extremity demonstrated no findings of DVT in 6 patients who had both limb pains and plasma D-dimer levels less than 3.0μg/ml. In conclusion, the diagnosis of DVT by venous ultrasonography should be done in patients with ovarian tumors when their plasma D-dimer levels were at least more than 3.0μg/ml. [Adv Obstet Gynecol, 63(3) : 271-276, 2011 (H23.8)]