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Recurrent stroke in a patient of lung cancer without pulmonary mass: A case report
Lisha Wang1, Yan Xu, Minghui Tuo
1Department of Neurology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province, People's Republic of China.
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.
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