A patient who underwent two thrombectomies within a week due to Trousseau syndrome: A case report

Background

Since the first description by Trousseau, substantial progress has been made in understanding the development of thromboembolic events associated with malignant tumors. The pathophysiological mechanism is understood to involve activation of the coagulation cascade by the tumor cells themselves or as a result of treatment, and only a few patients receive endovascular treatment for Trousseau syndrome. There is a lack of evidence that patients suspected of having Trousseau syndrome have received antiplatelet therapy or anticoagulant therapy, even after receiving antitumor treatment or anticoagulant therapy.

Case

A 66-year-old female was admitted to The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital on September 5, 2023 with a chief complaint of ’sudden-onset aphasia accompanied by right-sided weakness for more than 1 h.’ Within the first week of hospitalization, the patient underwent successive thrombectomies of the left middle cerebral artery and the basilar artery. After each thrombectomy, the patient’s NIH Stroke Scale (NIHSS) score improved. Abnormalities in coagulation function were detected during hospitalization, and chest CT revealed enlarged lymph nodes in the bilateral supraclavicular and hepatotactic regions. Lymph node aspiration biopsy confirmed the diagnosis of lung adenocarcinoma.

Conclusion

The patient did not experience recurrent stroke following the administration of rivaroxaban and ametinib. Multiple infarctions in different cerebral arterial supply areas caused by Trousseau syndrome are rare and require optimal planning involving endovascular treatment, antitumor therapy, and anticoagulant therapy.