Recurrent stroke in a patient of lung cancer without pulmonary mass

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.