Splanchnic Vein Thrombosis in Cancer Patients

Splanchnic vein thrombosis (SVT) is a rare manifestation of venous thromboembolism, which may complicate the clinical course of patients with intra-abdominal solid cancers and myeloproliferative neoplasms. Clinical manifestation of SVT varies and depends on the involved vessel, the rapidity of onset, and the condition of underlying malignancies. However, a substantial proportion of SVT is incidentally detected on imaging studies conducted for staging or restaging underlying malignancies. Cancer-associated SVT is a therapeutic challenge because of its rarity and limited clinical data. In general, SVT in cancer patients has a considerable long-term risk of thrombosis as in typical cancer-associated venous thromboembolism, and anticoagulation treatment is recommended to improve the recanalization rate and prevent recurrent thrombosis in the absence of high risk for bleeding. However, owing to the heterogeneous underlying conditions of malignancies, an individualized approach and treatment decision is needed for cancer-associated SVT. This review outlines the pathogenesis, risk factors, and diagnosis of cancer-associated SVT and discusses the treatment of this challenging disease.