warfarin and Femoral-Neoplasms

Deep venous thrombosis (DVT) is uncommonly seen in children and adolescents. A distal femoral osteochondroma causing isolated lower limb DVT is even rarer and to our knowledge only four such cases have been reported in the literature. We report a case of a solitary distal femoral osteochondroma in a 15-year-old adolescent presenting as isolated DVT. We highlight the potential of coexistence of DVT and osteochondroma in young patients. We also emphasize the importance of timely diagnosis and outline the plan of management when faced with such a rare condition.

Topics: Adolescent; Anticoagulants; Femoral Neoplasms; Humans; Magnetic Resonance Angiography; Male; Osteochondroma; Popliteal Vein; Tomography, X-Ray Computed; Venous Thrombosis; Warfarin

As both cancer and major orthopaedic surgery are risk factors for venous thromboembolism, patients undergoing lower-extremity oncologic endoprosthetic arthroplasty for neoplastic processes are at substantial risk of the development of symptomatic venous thromboembolism. Therefore, the primary purpose of this study was to determine the incidence of symptomatic venous thromboembolism in patients undergoing lower-extremity oncologic endoprosthetic arthroplasty. Secondary purposes were to assess whether chemoprophylaxis influenced the incidence of venous thromboembolism, surgical complications, or the incidence of local sarcoma recurrence. We also sought to determine whether any known risk factors for venous thromboembolism could be identified in this patient population.. We performed a retrospective comparative review of 423 patients who had undergone mega-endoprosthetic reconstruction following cancer resection. Univariate analysis was used to assess the association between chemoprophylaxis and the incidence of venous thromboembolism, to postulate the surgical complications associated with chemoprophylaxis, and to assess the rate of recurrence of local sarcoma as well the association between risk factors and venous thromboembolism.. Seventeen patients (4.0%) (95% confidence interval: 2.5% to 6.3%) had a venous thromboembolic event, ten with deep venous thrombosis and seven with nonfatal pulmonary embolism. Risk factors and chemoprophylactic regimens were not statistically associated with the occurrence of venous thromboembolism.. The incidence of symptomatic venous thromboembolism in our group of cancer patients who underwent lower-extremity endoprosthetic arthroplasty was lower than anticipated. A significant difference was not identified between the use of any or no chemoprophylactic agent and the incidence of venous thromboembolism or complication rates. No risk factors were associated with the incidence of symptomatic venous thromboembolism.

Topics: Adolescent; Adult; Anticoagulants; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Bone Neoplasms; Femoral Neoplasms; Heparin, Low-Molecular-Weight; Humans; Limb Salvage; Neoplasm Recurrence, Local; Pulmonary Embolism; Tibia; Venous Thromboembolism; Venous Thrombosis; Warfarin