Simultaneous multiple organ emboli in a patient with solid organ malignancy: a case report.

Area of Science:

• Cardiology
• Oncology
• Neurology

Background:

• Thrombosis is a significant complication in cancer patients, with high incidences of venous (20%) and arterial (1%) thrombotic events.
• Malignancy significantly elevates the risk of developing dangerous blood clots.

Purpose of the Study:

• To present a rare case of simultaneous venous and arterial thrombosis in a cancer patient.
• To investigate the underlying mechanisms of multiple, separate thrombus formation in the context of malignancy.

Main Methods:

• A case report of an 80-year-old woman with squamous cell lung cancer presenting with cardiac arrest.
• Diagnostic workup included ECG, CT head, aortogram, coronary angiogram, and transoesophageal echocardiography.
• Interventions involved aspiration thrombectomy, thrombolysis, and cerebral clot retrieval.

Main Results:

• The patient experienced an ST-elevation myocardial infarction, ischemic stroke, and bilateral pulmonary emboli.
• Successful thrombectomy and clot retrieval led to full neurological recovery within 72 hours.
• No intracardiac shunt was identified, suggesting separate thrombus formation in venous and arterial systems.

Conclusions:

• The case demonstrates separate venous and arterial thrombi formation, not due to paradoxical embolism.
• This highlights the critical prothrombotic state associated with malignancy.
• Emphasizes the need for vigilance regarding multiple thrombotic events in cancer patients.