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Portal tumor thrombus due to gastrointestinal cancer
H Ishida1, K Konno, Y Hamashima
1First Department of Internal Medicine, Akita University School of Medicine, 1-1-1 Hondo, Akita City, Japan,
Methods:
We studied the clinical data of seven patients with portal tumor thrombus (PTT) due to gastrointestinal (GI) cancer to determine the radiologic patterns and clinical implications of this rare complication.
Results:
(a) PTT was located along the entire splenic vein in three cases, at the splenomesenteric confluence in one case, and in the superior mesenteric vein in one case. Intrahepatic PTT occurred in two of four cases with liver metastasis. (b) One cirrhotic case was complicated by the occurrence of colon cancer associated with PTT in the splenic vein; the esophageal varices became rapidly enlarged and poorly controlled, and the patient died due to repeated variceal rupture. (c) In all patients, abdominal sonography (US) detected PTT and color Doppler sonography confirmed the US findings.
Conclusions:
The splenic vein should be meticulously observed by color Doppler sonography to check for PTT in patients with GI cancer to improve patient care.