[Recurrent ischemic strokes secondary to acquired hypercoagulability in a patient with prostatic adenocarcinoma].
Hypercoagulable states are frequently associated to malignancies. We report the case of a 67 year-old patient with prostatic cancer (T3NxM1) and deep venous thrombosis, whose initial coagulation studies were normal. He was treated with acenocumarol and hormonal blockade with flutamide and leuprolerin acetate. Six months later he developed recurrent brain ischemic strokes in the territories of both median cerebral arteries, that did not respond to anticoagulant treatment. Coagulation studies, showed a procoagulant activity with a probable paraneoplastic origin. We conclude that prostatic adenocarcinoma treated with hormonal blockage may promote a complex procoagulant state leading to recurrent occlusive arterial disease, refractory to anticoagulation.
Servicio de Neurología, Hospital de Gran Canaria Dr. Negrín Las Palmas de Gran Canaria, Spain. raul.amela@wanadoo.es
R
R
Amela
Y
Y
Aladro
C
C
Muñoz
I
I
Balda
D
D
Mendoza
D000230:Adenocarcinoma / Q000150:complications*; D000368:Aged; D001778:Blood Coagulation Disorders / Q000209:etiology*; D002545:Brain Ischemia / Q000209:etiology*; D002544:Cerebral Infarction / Q000209:etiology*; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000150:complications*; D012008:Recurrence