{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T09:21:51Z","timestamp":1778923311352,"version":"3.51.4"},"reference-count":16,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,4,1]]},"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:p>Phlegmasia cerulea dolens (PCD) is a rare, fulminant, potentially lethal and often debilitating presentation of deep venous thrombosis (DVT). Mortality and amputations rates are high. We present a rare case of bilateral PCD in the lower extremities. A 67-year-old woman presented with newly diagnosed squamous cell cancer of unknown primary origin with lymph node metastases to the neck. The patient started curatively intended treatment, consisting of removal of one lymph node on the neck, radiotherapy with concomitant carboplatin and nimorazol. The patient developed bilateral DVT in the legs. Despite treatment with low-molecular-weight heparins, the patient developed thrombosis in the inferior vena cava and lungs. Due to developing painful discolouration and necrosis on the legs, the patient underwent acute and extensive surgery. PCD is a severe and potentially lethal form of DVT. There are several known risk factors for developing DVT, including active cancer and the use of chemotherapy.<\/jats:p>","DOI":"10.1136\/bcr-2019-233760","type":"journal-article","created":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T05:05:24Z","timestamp":1586927124000},"page":"e233760","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Phlegmasia cerulea dolens in a patient treated with carboplatin"],"prefix":"10.1136","volume":"13","author":[{"given":"Martin","family":"S\u00f6derman","sequence":"first","affiliation":[{"name":"Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark"},{"name":"Department of Plastic Surgery, Odense University Hospital, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Grimm","sequence":"additional","affiliation":[{"name":"Department of Oncology, Odense University Hospital, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,4,14]]},"reference":[{"key":"2025082622563948000_13.4.e233760.1","doi-asserted-by":"publisher","DOI":"10.1177\/1538574410388309"},{"key":"2025082622563948000_13.4.e233760.2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800830106"},{"key":"2025082622563948000_13.4.e233760.3","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1177\/1538574417729274","article-title":"Management of post-traumatic phlegmasia cerulea dolens via right-to-left femoral vein to femoral vein bypass (Palma procedure)","volume":"51","author":"Dua","year":"2017","journal-title":"Vasc Endovascular Surg"},{"key":"2025082622563948000_13.4.e233760.4","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1160\/TH09-01-0053","article-title":"Comparative study on risk factors and early outcome of symptomatic distal versus proximal deep vein thrombosis: results from the OPTIMEV study","volume":"102","author":"Galanaud","year":"2009","journal-title":"Thromb Haemost"},{"key":"2025082622563948000_13.4.e233760.5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/978-3-030-20315-3_1","article-title":"Thrombosis and hemostasis in cancer. scope of the problem and overview","volume":"179","author":"Soff","year":"2019","journal-title":"Cancer Treat Res"},{"key":"2025082622563948000_13.4.e233760.6","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1097\/CAD.0000000000000625","article-title":"Venous thromboembolic events in patients with lung cancer treated with cisplatin-based versus carboplatin\/nedaplatin-based chemotherapy","volume":"29","author":"Mitani","year":"2018","journal-title":"Anticancer Drugs"},{"key":"2025082622563948000_13.4.e233760.7","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/978-3-030-20315-3_6","article-title":"Thrombotic risk from chemotherapy and other cancer therapies","volume":"179","author":"Debbie Jiang","year":"2019","journal-title":"Cancer Treat Res"},{"key":"2025082622563948000_13.4.e233760.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0189410","article-title":"Risk of thromboembolism in cisplatin versus carboplatin-treated patients with lung cancer","volume":"12","author":"Kim","year":"2017","journal-title":"PLoS One"},{"key":"2025082622563948000_13.4.e233760.9","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/bju.14685","article-title":"Chemotherapy regimen is associated with venous thromboembolism risk in patients with urothelial tract cancer","volume":"124","author":"Ramos","year":"2019","journal-title":"BJU Int"},{"key":"2025082622563948000_13.4.e233760.10","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1002\/cncr.29801","article-title":"The high incidence of vascular thromboembolic events in patients with metastatic or unresectable urothelial cancer treated with platinum chemotherapy agents","volume":"122","author":"Tully","year":"2016","journal-title":"Cancer"},{"key":"2025082622563948000_13.4.e233760.11","doi-asserted-by":"publisher","DOI":"10.1053\/snuc.2001.21406"},{"key":"2025082622563948000_13.4.e233760.12","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.emc.2017.06.003","article-title":"Deep venous thrombosis","volume":"35","author":"Olaf","year":"2017","journal-title":"Emerg Med Clin North Am"},{"key":"2025082622563948000_13.4.e233760.13","unstructured":"National Clinical Guideline Centre . National Institute for health and clinical excellence: guidance. venous thromboembolic diseases: the management of venous thromboembolic diseases and the role of thrombophilia testing. 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