Abstract

Background: Ovarian vein thrombosis is a rare condition, occurring most commonly in the postpartum or postoperative period, but has also been identified in cases of malignancy and infection. This report describes a case of chronic ovarian vein thrombosis that most likely developed postoperatively in a patient who was subsequently found to have a malignancy. Case: The patient is a 34-year-old woman, gravida 8 para 6025, who had a supracervical hysterectomy 13 months prior and presented with one year of lower abdominal pain. An ultrasound was normal, but computed tomography demonstrated a right ovarian vein thrombus. Hypercoagulable workup was normal. Five months after initiating treatment with anticoagulation, the patient developed bright red bleeding per rectum and was diagnosed with colon cancer. After her bleeding resolved, the decision was made to continue her on anticoagulation for a total of six months of treatment as her pain improved significantly on anticoagulation. Conclusion: This case demonstrates the challenges of treating a chronic thrombus. There are no clinical guidelines to recommend treatment of ovarian vein thrombus and typically duration of three months to six months of anticoagulation is recommended. Given the chronic appearing nature of the thrombus, it is most likely that a prolonged duration of anticoagulation was of more benefit to the patient.

Authors and Affiliations