Transit thrombus entrapped in a patent foramen ovale

We describe the case of a 39-year-old man with a diagnosis of inferior vena cava compression caused by metastases of a testicular seminoma, who developed massive pulmonary embolism. Emergency operation was performed because of acute hemodynamic deterioration. Preoperatively, a free-floating mass was...

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Bibliographic Details
Published in:Heart & lung 2004-05, Vol.33 (3), p.191-193
Main Authors: Huwer, Hanno, Winning, Johannes, Isringhaus, Helmut, Kalweit, Gerhard
Format: Article
Language:English
Subjects:
Adult
Echocardiography
Heart Septal Defects, Atrial - complications
Heart Septal Defects, Atrial - diagnosis
Humans
Male
Pulmonary Embolism - diagnosis
Pulmonary Embolism - etiology
Seminoma - complications
Testicular Neoplasms - complications
Thrombosis - diagnosis
Thrombosis - etiology
Tomography, Spiral Computed
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Summary:We describe the case of a 39-year-old man with a diagnosis of inferior vena cava compression caused by metastases of a testicular seminoma, who developed massive pulmonary embolism. Emergency operation was performed because of acute hemodynamic deterioration. Preoperatively, a free-floating mass was seen echocardiographically in the right atrium. Intraoperatively, a thrombus entrapped in a patent foramen ovale with a short free-floating end in the left atrium and a long end in the right atrium was found in addition to the pulmonary emboli. The thrombus was removed, the foramen ovale was closed by direct suture, and pulmonary embolectomy was performed. Histological examination confirmed thrombi but no malignant tissue. Further diagnostic studies documented a malignant seminoma with paraaortic lymph node metastases giving rise to the thrombembolism. Three years after oncologic therapy, he is alive and free from recurrence of embolic and malignant disease.
ISSN:0147-9563
1527-3288
DOI:10.1016/j.hrtlng.2003.12.006