Trousseau syndrome with intrahepatic cholangiocarcinoma that could be removed radically after endovascular treatment: Report of a case

Murahashi, Shuei; Takeuchi, Yosuke; Hayashida, Shintaro; Ohya, Yuki; Shindo, Seigo; Terasaki, Tadashi; Inomata, Yukihiro; Hara, Yasuyuki

doi:10.1002/brb3.1660

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…13,14) In these studies, risk factors of re-occlusion included the number of device passes, missed residual thrombus or stenosis on the past angiography after thrombectomy, intracranial ICA or M2 occlusion, stroke of undetermined cause, and statin pretreatment. 13,14) According to our research, there are 14 reported incidences of TS treated by MT with available literature [2][3][4]13,[15][16][17][18][19][20][21][22] (Table 1). Of half of the cases that experienced re-occlusion of the cerebral large vessels, five cases involved the same vessels.…”

Section: Discussionmentioning

confidence: 98%

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Multiple Thrombectomies for Cerebral and Coronary Artery Occlusion in Trousseau Syndrome

Sakaï

Tsurusaki

Mitsui

et al. 2022

JNET

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Objective: Trousseau syndrome (TS) is a condition of systemic thrombosis generally associated with an underlying malignancy. An ischemic stroke is a representative thrombotic event. Thrombectomy is a useful procedure for the treatment of cerebral large vessel occlusion, and anticoagulation therapy is the main preventive treatment for TS. This case report describes a woman with terminal pancreatic tumor presenting with repeated occlusions of cerebral and coronary arteries necessitating multiple thrombectomies.Case Presentation: A 67-year-old woman was admitted to our hospital with severe right hemiplegia and global aphasia.MRI revealed left M1 occlusion; therefore, a thrombectomy was performed. Her symptoms recovered completely. Body contrast CT revealed pancreatic cancer with multiple metastases, and she was diagnosed with TS. On day 4 after thrombectomy, the same neurological symptoms occurred and re-occlusion of the left M1 was confirmed. Endothelial injury was suspected, and thrombectomy was repeated. Despite continuing anticoagulation therapy, the coronary artery was occluded and she underwent percutaneous coronary intervention on day 13. To treat the primary pancreatic lesion, she was transferred to the Surgery unit on day 20. Conclusion:Hypercoagulability associated with TS and endothelial damage due to rough procedure resulted in repeated vessel occlusions in this case. Careful thrombectomy and anticoagulation therapy with strict monitoring are needed in TS patients.

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Section: Discussionmentioning

confidence: 98%

“…Nonetheless, the difficulty of medical therapy may depend on the progression or state of the primary lesion. 18 , 19) …”

Section: Discussionmentioning

confidence: 99%

Multiple Thrombectomies for Cerebral and Coronary Artery Occlusion in Trousseau Syndrome

Sakaï

Tsurusaki

Mitsui

et al. 2022

JNET

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“…Splenic infarction in hepatocellular carcinoma was formerly reported in sorafenib use 29 , post transcatheter arterial chemoembolization 30 , and post ethanol ablation 31 . Two recent case reports revealed splenic infarction in cholangiocarcinoma, depicted as Trousseau's syndrome 32 , 33 . There appears to be a high association with the hyper-coagulation system induced by mucin-producing adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Risk assessment and prognostic analysis of patients with splenic infarction in emergency department: a multicenter retrospective study

Yen

Wang

Chen

et al. 2021

Sci Rep

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Splenic infarction is a thromboembolic disease that is frequently missed in acute settings. Previous reviews were rarely presented from a clinical perspective. We aimed to evaluate the clinical characteristics, risk factors with diagnostic value, and prognostic factors using large cohort data and a matched case–control study method. A retrospective medical record review of six hospitals in Taiwan from January 1, 2005, to August 31, 2020, was conducted. All patients who underwent contrast CT with confirmed the diagnosis of splenic infarction were included. Their characteristics were presented and compared to a matched control group with similar presenting characteristics. Prognostic factors were also analyzed. A total of 130 cases were included, two-thirds of whom presented with abdominal pain. Atrial fibrillation was the most common associated predisposing condition, followed by hematologic disease. A higher proportion of tachycardia, positive qSOFA score, history of hypertension or atrial fibrillation, leukocytosis, and thrombocytopenia were found in splenic infarction patients compared to their counterparts. An underlying etiology of infective endocarditis was associated with a higher proportion of ICU admission. Splenic infarction patients often presented with left upper abdominal pain and tachycardia. A history of hypertension, atrial fibrillation, a laboratory result of leukocytosis or thrombocytopenia may provide a clue for clinicians to include splenic infarction in the differential list. Among the patients diagnosed with splenic infarction, those with an underlying etiology of infectious endocarditis may be prone to deterioration or ICU admission.

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Superficial Vein Thrombosis in an Asymptomatic Case of Cholangiocarcinoma with Recent History of COVID-19

Ciobica,

Sandulescu,

Sotcan

et al. 2024

Life

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The COVID-19 pandemic brought into prominence several emergent medical and surgical entities, but, also, it served as trigger and contributor for numerous apparently unrelated ailments such as arterial and venous thromboembolic complications. Additional risk factors for these thrombotic traits may be concurrent (known or unknown) malignancies, including at hepatic level. Among these, cholangiocarcinoma (CCA), a rare cancer of intra- and extra-hepatic biliary ducts, represents a very aggressive condition that typically associates local and distant advanced stages on first presentation requiring a prompt diagnosis and a stratified management. This neoplasia has been reported to present a large spectrum of paraneoplastic syndromes in terms of dermatologic, renal, systemic, neurologic, endocrine, and cardiovascular settings, that, overall, are exceptional in their epidemiologic impact when compared to other cancers. Our aim was to introduce a most unusual case of CCA-associated distant thrombosis in a male adult who initially was considered to experience COVID-19-related thrombotic features while having a history of obesity and bariatric surgery. This is a hybrid type of paper: this clinical vignette is accompanied by two distinct sample-focused analyses as a basis for discussion; they each had different methods depending on their current level of statistical evidence. We only included English-published articles in PubMed, as follows: Firstly, we conducted a search of reports similar to the present case, regarding distant vein thrombosis in CCA, from inception until the present time. We performed a literature search using the keywords “cholangiocarcinoma”, “thrombosis”, and “Trousseau’s syndrome” and identified 20 cases across 19 original papers; hence, the current level of evidence remains very low Secondly, we searched for the highest level of statistical evidence concerning the diagnosis of venous thrombosis/thromboembolism in patients who underwent COVID-19 infection (key search terms were “COVID-19”, alternatively, “coronavirus”, and “SARS-CoV-2”, and “thrombosis”, alternatively, “thromboembolism”) and included the most recent systematic reviews and meta-analyses that were published in 2024 (from 1 January 2024 until 8 July 2024). After excluding data on vaccination against coronavirus or long COVID-19 syndrome, we identified six such articles. To conclude, we presented a probably unique case of malignancy with an initial manifestation consisting of recurrent superficial vein thrombosis under anticoagulation therapy, with no gastrointestinal manifestations, in a patient with a notable history for multiple episodes of SARS-CoV-2 infection and a prior endocrine (gastric) surgery. To our knowledge, this is the first identification of a CCA under these specific circumstances.

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Trousseau syndrome with intrahepatic cholangiocarcinoma that could be removed radically after endovascular treatment: Report of a case

Cited by 3 publications

References 10 publications

Multiple Thrombectomies for Cerebral and Coronary Artery Occlusion in Trousseau Syndrome

Multiple Thrombectomies for Cerebral and Coronary Artery Occlusion in Trousseau Syndrome

Risk assessment and prognostic analysis of patients with splenic infarction in emergency department: a multicenter retrospective study

Superficial Vein Thrombosis in an Asymptomatic Case of Cholangiocarcinoma with Recent History of COVID-19

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