Acute cerebral infarction during combination chemotherapy with s-1 and cisplatin for a young patient with a mucin-producing adenocarcinoma of the stomach.
We report a 29-year-old woman with gastric cancer who developed Trousseau's syndrome, a malignancy-related thromboembolism, during chemotherapy. She was diagnosed with a mucin-producing adenocarcinoma of the stomach, and chemotherapy with S-1 and cisplatin was commenced. During treatment, she developed a sudden onset of right hemiplegia. Magnetic resonance imaging showed an acute cerebral infarction of the left cerebral hemisphere. The underlying pathophysiology is thought to be chronic disseminated intravascular coagulation due to mucin-producing adenocarcinomas. However, cisplatin-induced vascular toxicity and hypercoagulability caused by decreased plasma protein C activity, elevated plasma von-Willebrand factor levels, and hypomagnesemia has also been proposed to be associated with thrombogenicity.
Ohashi
Shinya
S
Department of Gastroenterology and Hepatology, Tazuke-Kofukai Medical Research Institute and Kitano Hospital, 2-4-20 Ogimachi, Kita-ku, Osaka 530-8480, Japan.
Yazumi
Shujiro
S
Nishio
Akiyoshi
A
Fukui
Toshiro
T
Asada
Masanori
M
Chiba
Tsutomu
T
D000208:Acute Disease; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D018279:Carcinoma, Signet Ring Cell / Q000150:complications / Q000188:drug therapy; D002544:Cerebral Infarction / Q000139:chemically induced / Q000209:etiology*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D004338:Drug Combinations; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D010094:Oxonic Acid / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000150:complications* / Q000188:drug therapy; D005641:Tegafur / Q000008:administration & dosage; D013923:Thromboembolism / Q000139:chemically induced / Q000209:etiology*
D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin