No abstract

Objective: Trousseau's syndrome, malignancy associated hypercoagulability, comprises polymorphic spectrum of arterial and venous thrombotic disorders in setting of neoplastic disease. We suspected that acute myocardial infarction in a patient with low cardiovascular risk and suspicious lung infiltration might be a presentation of Trousseau's syndrome. Methods: While waiting for diagnostic bronchoscopy, 49-year-old man with radiologically detected abnormal shadow in right lung hilum, suddenly developed myocardial infarction. The patient was treated and stabilized, however he died four days later, and clinical autopsy was performed. Results: Post mortem results revealed poorly differentiated lung adenocarcinoma in advanced stage. Blood clots were found in medium and small branches of coronary blood vessels not only in the field of myocardial infarction, but also in surrounding non-necrotic muscle. Ischemic infarcts were found in kidney and spleen. Occlusive thrombi and thromboemboli were found in veins and arteries of medium and small caliber in visceral organs, and in venous plexuses of the pelvis. Conclusion: Cancer associated hypercoagulability presented as myocardial infarction is very rarely encountered in clinical practice. Trousseau's syndrome as underlying cause of arterial thrombosis should be considered and investigated, especially for patients without clinical evidence of atherosclerosis.