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Deep Vein Thrombosis, Pulmonary Thromboembolism, Aortic Vegetation and Stroke in Advanced Lung Adenocarcinoma: A Case of Trousseau's Syndrome
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A4009 - Deep Vein Thrombosis, Pulmonary Thromboembolism, Aortic Vegetation and Stroke in Advanced Lung Adenocarcinoma: A Case of Trousseau's Syndrome
Author Block: J. Lee1, M. Kang1, S. Lee1, M. Park1, C. Choi2, J. Yoo2, B. Chang2; 1Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea, Republic of, 2Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea, Republic of.
Cancer-related hypercoagulability (also known as Trousseau’s syndrome) is not uncommon in a variety of cancer types including lung cancer. This paraneoplastic syndrome is usually diagnosed in patients with known malignancies. However, sometimes it can be a first manifestation in those without known cancer history. We recently experienced a patient presented with deep vein thrombosis (DVT), pulmonary thromboembolism (PTE), and non-bacterial thrombotic endocarditis (NBTE) who was then diagnosed with lung cancer-associated Trousseau’s syndrome. A 68-year-old woman visited the outpatient clinic complaining of leg edema and orthopnea. Imaging studies revealed DVT, PTE, and a mass at the right lower lobe of the lung. Biopsy and further imaging revealed that she had lung adenocarcinoma with multiple metastases and NBTE at aortic valve. We promptly started anticoagulation with low molecular weight heparin and planned systemic chemotherapy. However, massive cerebral infarction soon occurred and her condition deteriorated that she was unable to receive further treatment. Trousseau’s syndrome is associated with poor prognosis and is known as the second leading cause of death in patients with cancer. Therefore, clinicians should keep in mind that unexplained thrombotic events might be one of initial presentations of occult malignancy and active therapy for cancer itself and anticoagulation might be helpful for this potentially fatal complication.
Author Block: J. Lee1, M. Kang1, S. Lee1, M. Park1, C. Choi2, J. Yoo2, B. Chang2; 1Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea, Republic of, 2Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea, Republic of.
Cancer-related hypercoagulability (also known as Trousseau’s syndrome) is not uncommon in a variety of cancer types including lung cancer. This paraneoplastic syndrome is usually diagnosed in patients with known malignancies. However, sometimes it can be a first manifestation in those without known cancer history. We recently experienced a patient presented with deep vein thrombosis (DVT), pulmonary thromboembolism (PTE), and non-bacterial thrombotic endocarditis (NBTE) who was then diagnosed with lung cancer-associated Trousseau’s syndrome. A 68-year-old woman visited the outpatient clinic complaining of leg edema and orthopnea. Imaging studies revealed DVT, PTE, and a mass at the right lower lobe of the lung. Biopsy and further imaging revealed that she had lung adenocarcinoma with multiple metastases and NBTE at aortic valve. We promptly started anticoagulation with low molecular weight heparin and planned systemic chemotherapy. However, massive cerebral infarction soon occurred and her condition deteriorated that she was unable to receive further treatment. Trousseau’s syndrome is associated with poor prognosis and is known as the second leading cause of death in patients with cancer. Therefore, clinicians should keep in mind that unexplained thrombotic events might be one of initial presentations of occult malignancy and active therapy for cancer itself and anticoagulation might be helpful for this potentially fatal complication.
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