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Phlegmasia Cerulea Dolens after Ovarian Cancer Treatment with Bevacizumab: A Case Report

Belmaachi abderrafie,Sara ridai , Hassan Jouhadi, Souha Sahraoui, Zineb Bouchbika, Nadia Benchakroun, Nezha Tawfiq and Abdellatif Benider

Bevacizumab has been shown to improve progression-free survival in women with ovarian cancer in multiple clinical trials. However, serious adverse effects, such deep vein thromobosis, can occur.

Phlegmasia cerulea dolens is a rare entity secondary to grave Deep Vein Thrombosis (DVT), in the lower extremities, and associated with rapidly progressive pain and marked swelling that may compromise the perfusion of the limb. This situation may lead to venous gangrene and the limb’s amputation secondary to a compartment syndrome.

We present the case of a 45-year-old female who presented eight days after the fourth administration of bevacizumab for ovarian cancer treatment, a bilateral leg pain with progressive edema which also began to exhibitwith a black discoloration. Venous dopplers showed bilateral occlusions of the common femoral, saphenofemoral, superficial femoral, popliteal, posterior tibial and peroneal veins.

To our knowledge, this is the first case with bevacizumab associated Phlegmasia cerulea dolens.