Joann M. Lohr, MD, RVT, FACS

This article nicely describes concernsabout the underdiagnosisof deep vein thrombosis(DVT) and superficial vein thrombosisin patients with malignancy. Theincidence of these conditions in thissetting has been demonstrated to beas high as 51% in postmortem studies,as opposed to the clinically recognized15% rate. The articlereinforces the need for better diagnostictools than are currently availablein clinical practice. It alsostresses the need for a high clinicalsuspicion. Duplex ultrasound shouldbe used as a first step, and othermodalities listed in the article needto be used when appropriate.