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Portal vein thrombosis during antineoplastic chemotherapy in children: report of five cases and review of the literature.

Brisse H, Orbach D, Lassau N, Servois V, Doz F, Debray D, Helfre S, Hartmann O, Neuenschwander S

Imaging Department, Institut Curie, 26 rue d'Ulm, 75005 Paris, France. herve.brisse@curie.net

We report five paediatric cases of portal vein thrombosis (PVT) occurring during chemotherapy, observed in two institutions over an 8-year time period. These children aged 2.5-15 years were treated for Burkitt's lymphoma, Ewing's tumour, small cell bone tumour or medulloblastoma. PVT was diagnosed on colour Doppler ultrasonography (US). In four patients, thrombosis occurred 2-45 days after severe hepatic veno-occlusive disease (HVOD) secondary to intensive chemotherapy containing busulfan. In one case, PVT occurred in the absence of HVOD in a patient with pre-existing periportal lymphomatous infiltration. Four patients experienced persistent portal hypertension, which resulted in death in one. PVT during chemotherapy in children is a rare event and appears to be closely related to intensive chemotherapy containing busulfan and to be associated with HVOD.

Published 1 December 2004 in Eur J Cancer, 40(18): 2659-66.
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