Zusammenfassung
Insbesondere an Becken-/Beinvenen lokalisiert sind maligne Venenwandtumoren sehr selten. Im früheren Stadium, wenn sie noch nicht als Tumor tastbar sind, bieten sie am ehesten das Bild einer venösen Abflussstörung und fallen somit in der Thrombosediagnostik auf.
Sonographisch, wie auch phlebographisch kann der Tumor das Bild eines Thrombuszapfen zeigen. Aufgrund dieser Fehldiagnose kann es zu einer großen, prognoseverschlechternden Verzögerung bis zur Einleitung der adäquaten Therapie kommen. Anhand eines epitheloiden Hämangioendothelioms der V. femoralis communis wird gezeigt, wie sonographisch der Venenwandtumor von einem Thrombuszapfen differenziert werden kann. Die Literaturübersicht bestätigt die Problematik der frühzeitigen Diagnosestellung bei dem sehr seltenen malignen Venenwandtumor.
Abstract
Malignant vascular tumors located in pelvic/leg veins are extremely rare. At early stages, before the entity is palpable as a tumor, its presentation resembles more that of anomalous venous drainage, thereby falling within the scope of thrombosis diagnostics.
The tumor may mimic the clinical picture of a thrombotic plug on both sonography and phlebography, a misdiagnosis that may lead to a prolonged, prognosis-worsening delay before appropriate therapy is initiated. Using an epithelioid hemangioendothelioma of the common femoral vein as an example, a ultrasonographic approach to differentiating between a vascular tumor and a thrombotic plug is presented. The literature review confirms the challenges of early diagnosis in this extremely rare, malignant vascular tumor.
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Compliance with ethic guidelines
Conflict of interest W. Schäberle, G. Rupp-Heim, L. Leyerer, R. Kabiri, K. Bader, P. Richter, S. Riedl declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study.
Additional informed consent was obtained from all patients for whom identifying information is included in this article.
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Schäberle, W., Rupp-Heim, G., Leyerer, L. et al. Thrombuszapfen oder Venenwandtumor. Gefässchirurgie 18, 216–221 (2013). https://doi.org/10.1007/s00772-013-1148-2
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DOI: https://doi.org/10.1007/s00772-013-1148-2
Schlüsselwörter
- Malignes epitheloides Hämangioendotheliom
- Duplexsonographie
- Venenwandtumor
- Leiomyosarkom
- Venenthrombuszapfen