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Spontaneous Massive Retroperitoneal Hematoma: A Rare Complication of Anticoagulation after Stenting in Malignant Superior Vena Cava Syndrome

Year: 2025

Type: article

Abstract: Introduction: Superior vena cava (SVC) syndrome is a well-recognized complication of thoracic malignancies, most commonly small-cell lung cancer. Endovascular stenting is preferred because it provides rapid symptom relief and restores venous patency. However, the role of post-stenting anticoagulation remains controversial, and complications related to its use are rarely reported. We describe such a case in a patient with malignant SVC syndrome. Case Presentation: A 51-year-old woman with small-cell carcinoma of the lung and SVC syndrome underwent stenting of the SVC. After the procedure, she was on prophylactic low-molecular-weight heparin and developed a large retroperitoneal hematoma with a significant decrease in hemoglobin on day four. The patient was managed with a transfusion and conservative care. Massive retroperitoneal hematomas secondary to anticoagulation therapy after SVC stenting are highly uncommon. Conclusion: There is currently no consensus guideline on post-stenting anticoagulation in malignant SVC syndrome. This case highlights one of the problems encountered in the post-stenting scenario of malignant SVC syndrome.

Source: Case Reports in Oncology

DOI: 10.1159/000548600

Authors: Debanjan Nandi, Saurabh Raj, Sanjeev Kumar, Amarinder Singh, Rudrakshi Mahaldar

Institutions: All India Institute of Medical Sciences, Kalyani, All India Institute of Medical Sciences

Language: English

Topic: Case Reports on Hematomas

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,170