title: [A Case of Early-Onset Rapidly Progressive Cerebral Infarction with Trousseau's Syndrome in a Patient with Pancreatic Cancer Undergoing Surgery].
abstract: Trousseau's syndrome refers to cerebral infarction associated with hypercoagulability caused by cancer. Here, we report a case of Trousseau's syndrome in a patient with pancreatic cancer undergoing surgery. A 71-year-old woman was diagnosed with pancreatic head cancer with portal vein invasion; she underwent pancreaticoduodenectomy combined with portal vein resection. Pathological examination showed poorly differentiated adenocarcinoma with para-aortic lymph nodal metastasis. Although the patient had an uneventful postoperative course, she suddenly developed right hemiplegia and dysarthria 6 weeks after surgery, resulting in multiple cerebral infarctions scattered over both hemispheres. Owing to elevated D-dimer and CA125 levels as well as multiple liver metastases, the patient was diagnosed with Trousseau's syndrome and treated using heparin-based anticoagulant therapy. However, her cerebral infarction progressed rapidly and she died within 35 days of admission. Therefore, Trousseau's syndrome should be suspected when a patient with cancer is diagnosed with cerebral infarction, and anticoagulation therapy with heparin should be promptly initiated.
authors.affiliation: Dept. of General Surgery, Graduate School of Medicine, Chiba University.
authors.forename: Norikazu
authors.initials: N
authors.lastname: Yogi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nojima
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohtsuka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kato
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yoshitomi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Furukawa
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Takayashiki
authors.forename: Shigetsugu
authors.initials: S
authors.lastname: Takano
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuboki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Suzuki
authors.forename: Nozomu
authors.initials: N
authors.lastname: Sakai
authors.forename: Shingo
authors.initials: S
authors.lastname: Kagawa
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000601:surgery; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000188:drug therapy* / Q000209:etiology; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008207:Lymphatic Metastasis; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D013577:Syndrome; D013997:Time Factors
chemical_list: D000925:Anticoagulants; D006493:Heparin