Germ Cell Tumour of the Ovary Presenting with Chylothorax and Central Vein Thrombosis: A case report

Chylothorax is an uncommon entity associated with various processes that damage or obstructs the thoracic duct (TD) and its tributaries causing chyle to leak into the pleural space. We reported the case of a 20 year old girl who presented with bilateral chylothorax secondary to central vein thrombosis in a case of germ cell tumour of the ovary. Her contrast enhanced computerised tomography for thorax and abdomen revealed abdomino-pelvic mass with ascitis, bilateral pleural effusion, mediastinal lymphadenopathy and thrombosis of left internal jugular, brachiocephalic veins, right subclavian vein and bilateral pulmonary artery lobar branches thrombosis. Germ cell tumour ovary was diagnosed in view of her characterstic tumour marker pattern. Patient was managed conservatively with low molecular weight heparin, pigtail inter-costal drain and diet modification. Chemotherapy was started as soon as she was hemodynamically stabe which helped in early resolution of precipitating factor. There was complete resolution of the thrombosis. She responded to chemotherapy and successfully went on to have fertility preserving surgery. There was no residual tumour in surgical specimen and she has been kept on follow up in post-operative period. At six months follow up she continues to be disease free.