Soft tissue sarcomas may present with deep vein thrombosis

Purpose: To bring attention to our observation that soft tissue sarcomas may present initially as deep venous thromboses (DVTs). Method: A query of our health system database (1996 to 2004) for patients diagnosed with soft tissue sarcomas and DVTs was undertaken. Patient medical records were reviewed to select those patients whose DVT occurred before the diagnosis of their tumor. Patient demographics, tumor classification, presentation, and outcome were noted. Results: Six of 19 patients were identified (four men, two women; aged 41 to 85 years). All tumors occurred in the lower extremities. All DVTs occurred in the same extremity as the tumor. Pathology specimens indicated four different types of sarcomas. In five cases, sarcoma diagnosis was delayed as treatment of the DVT occurred. In one, a mass was seen on the initial venous duplex screen. Four are deceased, one remains in treatment, and one was lost to follow-up. The average length of follow-up was 10 months. Conclusion: Soft tissue sarcomas can initially present as, or even be misdiagnosed as, DVT. Given a delay in diagnosis adversely affects prognosis, it is important that physicians be vigilante for associated tumors when evaluating for suspected DVT.