[Acute venous thrombosis: localization, extent and aetiology with special consideration of paraneoplasia]

Among 279 consecutive patients (average age 53.8 years) with acute venous thrombosis, "complete" or "nearly complete" search for neoplasm was undertaken in 93 (average 60.6 years), "not complete" search in 186 (average 50.1 years). Subsequently the patients were followed regularly for possible malignant tumour (average follow-up period 36.9 months). In the group as a whole the following causes of thrombosis were identified: contraceptives 9.3%; post-operative 9%; malignant tumour diagnosed immediately or within 12 months 5.8%; traumatic 5%; immobilization 3.2%; post-partum 2.9%; diverse other causes 8.2%; unknown 59.5%. Neoplasm was found in 12.9% of 93 somewhat older "completely" examined patients. Taking into account age, 7.8% of all patients over 50 years developed thrombosis in association with neoplasm. In 6 of 16 patients with malignant tumour the venous thrombosis followed a particular course. Extensive thromboses in several bouts predominated. In 48.4% there were three-bout thromboses, in a further 27.4% four-bout thromboses involving also the pelvic vein. Isolated lower-leg venous thrombosis occurred in 9.2%, while the remaining one or multiple-bout thromboses occurred only in a few. Massive pelvic and leg vein thrombosis occurred in 43% of patients with malignant neoplasm, much more frequently than in those without neoplasm.