Ovarian vein thrombosis and metastatic colonic carcinoma

Case contributed by Amr Farouk
Diagnosis almost certain

Presentation

Work-up for colon cancer.

Patient Data

Age: 35 years
Gender: Female

Moderate circumferential mural thickening of the splenic flexure involving a 7 cm segment reaching a maximal thickness 1.7 cm with luminal attenuation seen. Associated smudged peri-colic fat planes & enlarged peri-colic lymph nodes are seen. Other pathologically enlarged lymph nodes are seen at porta hepatis & celiac regions. Multiple metastatic cystic hypodense hepatic focal lesions.

Right ovarian vein is seen distended with intra-luminal low-attenuation thrombus extending until its entry into the IVC.

Mild pelvic ascites.

Case Discussion

Ovarian vein thrombosis arises due to venous stasis and hyper-coagulability, which are commonly present in the recently postpartum patient. Other conditions that are associated with hyper-coagulability, such as recent surgery, malignancy and Crohn's disease also increase the patient's risk for ovarian vein thrombosis.

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