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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 co-existance 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