Aortic thrombus in a patient with myeloproliferative thrombocytosis, successfully treated by pharmaceutical therapy: a case report

Abstract

Introduction: Thrombosis in myeloproliferative thrombocytosis occurs usually in the microvessels and medium-sized arteries and veins and only rarely in the aorta. Aortic thrombosis is usually treated with thrombectomy. Reported here is a rare case that was treated pharmacologically.

Case presentation: A 60-year-old Japanese woman presented with numbness of both lower extremities. Her platelet count was 1787 x 103/mul. Through bone marrow examination, we diagnosed her condition as myelodysplastic and/or myeloproliferative disorder-unclassifiable. Abdominal ultrasonography and computed tomographic scan revealed aortic thrombosis. Her platelet count was controlled with hydroxyurea and ranimustine. Aspirin and ticlopidine improved the numbness in both lower limbs on the second day. Aortic thrombosis was not observed in a computed tomographic scan on the seventh day.

Conclusion: For aortic thrombosis, surgical management is usually adopted, but pharmacological management is also an option because of its immediate curative effects.

Figure 1

Enhanced computed tomography scan before treatment. A thrombus is observed in the lower-line aortic blood vessel at the level of the diaphragm.

Figure 2

Enhanced computed tomography scan after seven days of treatment. The circular thrombus has disappeared. However, there is a low density area in the same spot, which was identified as a wall thrombosis.