The Conundrum of Cancer-Associated Thrombosis: Lesson Learned from Two Intriguing Cases and Literature Review

Area of Science:

• Oncology
• Hematology
• Cardiology

Background:

• The link between cancer and venous thromboembolism (VTE) is well-established.
• Cancer-related arterial thromboembolism (ATE) requires further investigation into its pathogenesis.
• Understanding cancer-associated thrombosis (CAT) is crucial for patient management.

Observation:

• Two cases highlight the complexity of thrombosis in cancer patients.
• A rectal cancer patient on fluoropyrimidines experienced catheter-related VTE and subsequent coronary artery thrombosis.
• A bladder cancer patient on platinum-based chemotherapy developed acute myocardial infarction shortly after treatment.

Findings:

• Cancer therapies, including fluoropyrimidines and platinum-based regimens, may be associated with arterial thrombotic events.
• These cases suggest a potential link between venous and arterial thrombotic events in cancer patients.
• The complexity of cancer-associated thrombosis (CAT) warrants attention.

Implications:

• Physicians should be vigilant about the thrombotic risks associated with specific anticancer therapies.
• Prophylactic strategies for thrombosis in cancer patients may need re-evaluation.
• Further research is needed to elucidate the mechanisms underlying cancer-related arterial thromboembolism (ATE).