Acute aortic thrombosis in patients receiving cisplatin-based chemotherapy

Abstract

The increased risk of thrombosis in patients with active cancer has multiple causes. Acute thrombosis of the aorta is an exceedingly rare but potentially devastating complication in patients with cancer receiving cisplatin-based chemotherapy. Prompt diagnosis and definitive treatment are imperative to decrease morbidity and mortality. Early diagnosis is difficult because initial presentation is often nonspecific, requiring a high degree of clinical suspicion. We report 4 cases of acute thrombosis of the abdominal aorta in patients with cancer receiving cisplatin-based chemotherapy. We review the clinical aspects, recommended investigation, and treatment of this potentially fatal complication.

Keywords: Acute; aortic occlusion; aortic thrombosis; arterial; cancer; cisplatin.

FIGURE 1

Enhanced computed tomography imaging (sagittal reformation) in a 60-year-old woman with rectosigmoid cancer receiving cisplatin-based chemotherapy shows extensive non-occlusive thrombus in the abdominal aorta (arrows).

FIGURE 2

Enhanced computed tomography imaging (axial) in a 53-year-old man with small-cell lung cancer 4 days after completion of cisplatin-based chemotherapy demonstrates an acute thrombus in the abdominal aorta (arrow) causing nearly complete occlusion of the lumen (thin arrow). The left renal artery was occluded (outside current slice), resulting in infarct of the left kidney (arrowheads).