Recurrent cerebral infarcts secondary to marantic endocarditis in a patient with adenocarcinoma of the lung

Tai, Mei‐Ling Sharon; Tan, Eugene Choon Li; Ang, Choon Chin; Liam, Chong Kin

doi:10.11622/smedj.2016157

Cited by 5 publications

(6 citation statements)

References 5 publications

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“…Cancer-associated ischemic stroke preceded or coincided with the detection of lung cancer in three of these six patients (10,11,14). Two patients developed CAIS during TKI treatment: one patient developed symptoms two days after the start of the TKI (12), and the other one during interruption TKI due to adverse effects of the TKI (15). One patient developed CAIS during the course of cytotoxic chemotherapy after development of TKI resistance (13).…”

Section: Casementioning

confidence: 91%

“…To our best knowledge, there have been six case reports of EGFR-mutant NSCLC patients with CAIS (10)(11)(12)(13)(14)(15). Cancer-associated ischemic stroke preceded or coincided with the detection of lung cancer in three of these six patients (10,11,14).…”

Section: Casementioning

confidence: 93%

“…The PFS and OS of our two patients were 17 and 22 months for case 1 and 5 and 14 months for case 2, respectively. Among the above-mentioned six EGFR mutated NSCLC patients with CAIS, four cases of PFS were described in their reports, and median PFS of them was four months (2-10 months) (10,14,15). Overall survival was described in five patients, with their median OS being eight months (1-22 months) (10-12, 14, 15).…”

Section: Casementioning

confidence: 99%

“…We herein report two EGFR-mutated patients with CAIS: concomitant diagnosis of lung cancer and CAIS in one patient, and metachronous diagnosis of CAIS during a dministration of cytotoxic anticancer drugs after development of EGFR-TKI resistance in another patient. CAIS in patients with EGFR-positive NSCLC has been reported to occur before, during, or after TKI therapy (10)(11)(12)(13)(14)(15). It is important to pay attention to the development of CAIS even in EGFR gene-positive patients who could be e xpected to have a long-term survival.…”

Section: Introductionmentioning

confidence: 99%

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EGFR Mutated Non-Small Cell Lung Cancer Complicated by Cancer Associated Ischemic Stroke

TAGUCHI,

KAWAKAMI,

HASEGAWA

et al. 2023

Maedica

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We describe herein two patients with epidermal growth factor receptor (EGFR) mutated non-small cell lung cancer (NSCLC) who developed cancer-associated ischemic stroke (CAIS), infarction caused by thromboembolism in the central nervous system. Case 1 was a 63-year-old man with Exon 19 deletion type EGFR mutated lung adenocarcinoma presenting with CAIS. Case 2 was a 71-year-old woman with Exon 21 L858R type EGFR mutated lung adenocarcinoma who developed CAIS during chemotherapy after EGFR-tyrosine kinase inhibitor (TKI) resistance. Although there was no recurrence of CAIS in these patients, anticancer therapy could be hampered by the comorbidity of CAIS. This can develop anytime from before clinical manifestations of NSCLC to the next treatment after EGFR-TKI resistance. The development of CAIS should be noted in patients with EGFR mutated NSCLC, who have a promising long-term prognosis. Anticancer and anticoagulant therapies as well as rehabilitation are important for patients who develop CAIS. Establishment of measurement tests to detect CAIS before onset is desired.

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Section: Casementioning

confidence: 91%

Section: Casementioning

confidence: 93%

Section: Casementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

EGFR Mutated Non-Small Cell Lung Cancer Complicated by Cancer Associated Ischemic Stroke

TAGUCHI,

KAWAKAMI,

HASEGAWA

et al. 2023

Maedica

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“…Reported cases of NBTE in patients with lung cancer confirm that necrotic skin lesions as the first presenting symptom are rare [6]. Heart murmurs are frequently absent in NBTE and the diagnosis is usually missed; therefore, transesophageal echocardiography (TEE) is a necessary diagnostic test [7].…”

Section: Introductionmentioning

confidence: 99%

Nonbacterial Thrombotic Endocarditis and Widespread Skin Necrosis in Newly Diagnosed Lung Adenocarcinoma

Zakka¹,

Zakka²,

Davarpanah³

et al. 2020

Case Rep Oncol

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Nonbacterial thrombotic endocarditis (NBTE) is a rare entity most commonly diagnosed postmortem with rates in autopsy series ranging from 0.9 to 1.6%. A 63-year-old female with past medical history of hypertension and mitral valve prolapse presented to the hospital with shortness of breath, headache, and necrotic skin lesions on her hands and feet. Computed tomography (CT) scan of her chest demonstrated a pulmonary embolus in the right lower lung segmental artery and right upper lobe lobar to segmental pulmonary artery, a mass-like consolidation in the left upper lung field impeding the hilum. CT scan of the abdomen demonstrated metastatic disease in liver and bone and bilateral femoral deep vein thrombosis. Transesophageal echocardiography revealed severe mitral regurgitation with two small mobile plaques on the mitral valve and two immobile plaques on the descending aorta. Magnetic resonance imaging of the brain was consistent with subacute infarcts and metastatic disease. Bronchoscopy was performed and pathology revealed primary adenocarcinoma of the lung. She was treated with anticoagulation and systemic chemotherapy. The patient and family elected to proceed with hospice due to her clinical decline, poor performance status, and poor prognosis after a prolonged hospital stay. Underlying malignancy is detected in approximately 40-85% of patients with NBTE. Lung cancer is the most frequently associated malignancy followed by pancreatic, stomach, breast, and ovarian cancer. Widespread necrotic skin lesions as presenting symptoms of primary lung adenocarcinoma are rare. In the present case, the diagnosis of necrotic skin lesions and NBTE preceded that of the neoplastic disease. Necrotic skin lesions and NBTE can be the first manifestations of an occult malignancy causing extensive multi-organ infarcts. NBTE can present with such extensive skin lesions as a first presenting sign of malignancy. To the best of our knowledge, this is the first case to present with such extensive skin lesions as the first presenting symptom of lung adenocarcinoma.

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Severe Nonbacterial Thrombotic Endocarditis Resulting in Aortic Valve Insufficiency and Multiple Small Strokes in a Patient With Metastatic Pancreatic Cancer: Lessons for Optimal Management

Collienne

Kuhns²,

Hauber

et al. 2020

Clinical Colorectal Cancer

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Recurrent cerebral infarcts secondary to marantic endocarditis in a patient with adenocarcinoma of the lung

Cited by 5 publications

References 5 publications

EGFR Mutated Non-Small Cell Lung Cancer Complicated by Cancer Associated Ischemic Stroke

EGFR Mutated Non-Small Cell Lung Cancer Complicated by Cancer Associated Ischemic Stroke

Nonbacterial Thrombotic Endocarditis and Widespread Skin Necrosis in Newly Diagnosed Lung Adenocarcinoma

Severe Nonbacterial Thrombotic Endocarditis Resulting in Aortic Valve Insufficiency and Multiple Small Strokes in a Patient With Metastatic Pancreatic Cancer: Lessons for Optimal Management

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