A CASE OF PORTAL VEIN THROMBOSIS DEVELOPED DURING HORMONE THERAPY FOR BREAST CANCER

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A 51-year-old woman was admitted to the hospital because of left advanced breast cancer. On admission the coagulation system was normal. After chemotherapy, a left modified radical mastectomy was performed. Histopathological findings included invasive ductal carcinoma, scirrhous carcinoma, s, and n3(+). Oral administration of toremifene citrate (TOR), doxifluridine (5'DFUR), and medroxyprogesterone acetate (MPA) was started. On the 75th day after administration, remarkable ascites and edema of the lower extremities were noted. Abdominal CT scan revealed a large amount of ascites and thrombotic obstraction. Abdominal angiography revealed complete obstraction of the portal vein and a development of collateral vessel. Since only medication could not control the ascites and abdominal distention and respiratory impairment became worse, a shunt between peritoneal space and vein was made, leading to a remission of patient's subjective symptoms. The patient, however, died of aggravated hepatic failure 8 months after the first operation. The causative relation between MPA and thrombosis has not been clarified as yet, but it is inferred that portal vein thrombosis may be caused by MPA because no obvious other causes are present.
日本臨床外科学会の論文