Case History/examination
In August 2023, a 95-year-old man presented to the emergency room at Razi Hospital in northern Iran with complaints of asymmetric leg pain and swelling in both legs, particularly in his left foot. The swelling began two weeks ago and worsened over the past two days. He denied having a fever, difficulty breathing, rapid heartbeat, chest or abdominal pain, or weight loss. In addition to the foot swelling, he mentioned experiencing mild dysuria for an extended period without being able to specify when it started. His medical history included hypertension, ischemic heart disease, benign prostatic hyperplasia (BPH) a previous hospitalization three years ago for COVID-19, cataract surgery, and surgical removal of a basal cell carcinoma (BCC) on his forehead. He also reported having multiple sexual partners over the past two decades. The entire leg exhibited swelling, with the calf showing more than 3 cm of swelling compared to the other leg. Localized tenderness was noted along the deep venous system, and pitting edema was observed in the left leg.