A Rare Case of Linear Phlebolith: Foreign Body Discovered in the Femoral Vein

Tariq Alanezi1, Abdulmajeed Altoijry1, Kaisor Iqbal1

  • 1Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia.

Case Reports in Surgery
|January 23, 2025
PubMed

Introduction: Phlebolith is a term that refers to round-shaped calcified thrombi commonly located in the pelvic region. The occurrence of dense, linear calcifications or phlebolith-like formations within the soft tissues of the lower extremities, particularly in the superficial femoral, greater saphenous, or popliteal veins, is rare. Patient Concerns: This study presents the case of a 73-year-old woman who was being evaluated for postmenopausal bleeding. During the patient's diagnostic workup, an incidental linear-shaped phlebolith was discovered. She had a positive history of deep vein thrombosis (DVT) for 36 years following her previous vaginal delivery. Diagnosis: Upon further examination and imaging, the patient was found to have a chronic calcified thrombus in the iliofemoral, popliteal, great saphenous, and superficial femoral veins, which was initially reported as a foreign body in the femoral vein on computed tomography (CT). Interventions and Outcomes: Conservative management was undertaken, with no worsening of her condition upon further follow-up. Conclusion: This study showcased a rare form of a radiographically visible calcified thrombus in the veins of the lower extremities of our patient. Calcified venous thrombosis in the lower extremities is rare, as previously documented cases of venous calcifications have been observed in the pelvis with round shapes or as phleboliths. The common presentations differ from those in our case, making it important to consider such cases when formulating a differential diagnosis. While the precise mechanisms behind the formation of calcified thrombi remain unclear, this study emphasizes the significance of further exploration and future case studies to shed light on this enigmatic phenomenon.