Rare Presentation of Pancreatic Cancer: A Case Report

Abstract

Introduction: Hypercoagulable state may be an important first presentation in malignancies especially pancreatic cancer. The trousseau syndrome is caused by venous thrombosis, non-bacterial thrombotic endocarditis and arterial thrombosis. We describe a patient who had the cerebral infarction as the initial manifestation of pancreatic cancer and we discuss that full work up for every patient with atypical stroke should be done. Case Presentation: We report a 67-year-old man who developed multiple cerebral infarctions as the initial manifestation of pancreatic cancer. Cancer antigen 19-9 (CA 19-9) was 52,065 U/mL (Normal value: 0 -33 U/mL), computerized tomography (CT) scan of the abdomen showed multiple hypodensities in both lobes of the liver and Heterogeneous hypodensity was seen in the pancreas that was highly suggestive of pancreas adenocarcinoma and was confirmed with the biopsy. Conclusions: In the case of multiple brain infarctions in both anterior and posterior circulation, without evidence of common cause, trousseau syndrome and hypercoagulability state should be considered.

Treatment Outcomes and Risk Factors Associated with Unsuccessful Treatment Outcomes among Extra Pulmonary Tuberculosis Patients

“…The mortality rate among patients with meningeal TB in this study was 17.4%, and the loss to follow-up rate was 8.3%, which was higher than other types of EPTB. Other studies from the United States, Iran, and Pakistan have also reported meningeal TB as a significant risk factor for unfavorable treatment outcomes [4,40,41].…”

Recurrent Strokes as the First Presentation of Occult Pancreatic Cancer; Trousseau Syndrome: A Case Report

“…Whole-body positron emission tomography followed by CT abdomen confirmed the presence of pancreatic cancer. Most pancreatic malignancies are invasive ductal carcinomas that infiltrate adjacent organs [ 15 ]. It is rarely diagnosed in its early stages, and as a result, it is mostly incurable in the majority of instances [ 15 ].…”

“…Most pancreatic malignancies are invasive ductal carcinomas that infiltrate adjacent organs [ 15 ]. It is rarely diagnosed in its early stages, and as a result, it is mostly incurable in the majority of instances [ 15 ]. The initial step in treating Trousseau's condition is to remove the underlying tumor, although this is not always feasible because the tumor is frequently unresectable [ 15 ].…”

“…It is rarely diagnosed in its early stages, and as a result, it is mostly incurable in the majority of instances [ 15 ]. The initial step in treating Trousseau's condition is to remove the underlying tumor, although this is not always feasible because the tumor is frequently unresectable [ 15 ]. Despite all preventive measures, including low molecular weight heparin and novel oral anticoagulants, the patient experienced repeated strokes followed by pulmonary embolism and died 2 months after admission.…”

Cortical Vein Thrombosis after Infliximab Treatment for Crohn’s Disease

“…The vein of Labbe, also known as the inferior anastomotic vein, is one of the cortical veins that anastomoses between the middle cerebral vein and transverse sinus and drains the lateral temporal lobe’s blood [ 3 ]. Risk factors for cerebral vein thrombosis include trauma, inherited and acquired thrombophilia, malignancy, exogenous hormones and pregnancy [ 2 , 4 ].…”