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Medical Science Monitor Basic Research


Recurrent Stroke Due to Pulmonary Vein Thrombosis in a Patient with Metastatic Lung Adenocarcinoma

Challenging differential diagnosis, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology

Haider Aldiwani, Abdelrahman Ahmed, Kartik Kumar, Mohamed Shokr, Shaun Cardozo

USA Department of Internal Medicine, Scripps Mercy Hospital Chula Vista, San Diego, CA, USA

Am J Case Rep 2020; 21:e923554

DOI: 10.12659/AJCR.923554

Available online: 2020-06-04

Published: 2020-07-26


BACKGROUND: Pulmonary vein thrombosis (PVT) is a rare clinical entity. Etiologies include malignancy, hyper-viscosity syndromes, and other etiologies. Patients may present with dyspnea, cough, or hemoptysis.
CASE REPORT: We present a case of a 64-year-old man with a history of metastatic lung cancer diagnosed with PVT through transesophageal echocardiography (TEE) and complicated by 2 cerebrovascular accidents. The patient had a complicated hospital course and died later due to his malignancy burden and overall condition, despite anticoagulation therapy.
CONCLUSIONS: Patients with PVT are often asymptomatic or may have a nonspecific clinical presentation. Anticoagulation should be considered in patients with PVT given the life-threatening complications such as peripheral embolization. More research is needed to address this potentially catastrophic finding.

Keywords: Embolism and Thrombosis, Lung Neoplasms, Pulmonary Veins