Recurrent stroke in a patient of lung cancer without pulmonary mass: A case report

Medicine (Baltimore). 2018 Feb;97(5):e9815. doi: 10.1097/MD.0000000000009815.

Abstract

Rationale: Repeated occurring stroke in short intervals with hypercoagulability is unusual so in such cases the conventional vascular risk factors might not be the causes of stroke.

Patient concerns: We have presented a case of 60-year-old male presenting with recurrent stroke due to thrombophilia.

Diagnoses: Lung cancer was detected by superficial lymph nodes ultrasound and further pathological examination.

Interventions: The patient suffered a recurrent stroke and he had persistently high level of D-dimer which suggested the diagnosis of thrombophilia, thus, he was treated with low-molecular-weight heparin. Unfortunately, the treatment was not effective for the patient and he died before any other treatments could be administered.

Outcomes: Despite anticoagulant therapy, the patient suffered multiple episodes of stroke and ultimately died.

Lessons: This case of recurrent stroke with coagulation disorders without evidence of cancer in imaging and blood test is rare. So in a stroke patient, we should consider malignancy or metastasis as a differential diagnosis as it may be the first manifestation of active cancer elsewhere.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / therapeutic use
  • Fatal Outcome
  • Humans
  • Lung Neoplasms / complications*
  • Lung Neoplasms / diagnosis
  • Male
  • Middle Aged
  • Recurrence
  • Stroke / diagnosis
  • Stroke / drug therapy
  • Stroke / etiology*
  • Thrombophilia / complications*

Substances

  • Anticoagulants