Lung adenocarcinoma initially presenting as Trousseau's syndrome treated successfully with pembrolizumab: A case report

The prognosis in patients with NSCLC initially presenting as Trousseau's syndrome is extremely poor. This is the first report in which a patient was successfully treated with DOAC and immune ‐check point inhibitor in lung adenocarcinoma initially presenting as Trousseau's syndrome. A 60 ‐year‐old woman was urgently admitted to our hospital because of vertigo and left hemiplegia. Laboratory examination showed thrombocytopenia, high levels of D‐dimer and carcinoembryonic antigen. Brain magnetic resonance imaging (MRI) revealed multiple bilateral cerebral infarctions. Chest comp uted tomography (CT) showed an irregularly shaped tumor in the upper lobe of the left lung and mediastinal node swelling. The histopathological findings revealed adenocarcinoma negative for anaplastic lymphoma kinase fusion gene, sensitive epidermal growth factor receptor mutations. A diagnosis of l ung adenocarcinoma initially presenting as arterial thromboembolism was made, and she was treated with direct oral anticoagulant (DOAC). Subsequently, pembrolizumab therapy was initiated because tumor cells were positive for programmed cell death protein 1 (PD‐L1;60%), and resulted in reduction of the tumor with normalization of the platelet count and d‐dimer. The treatment has been continued for over one year without any recurrence of the disease or thromboembolism.
Source: Thoracic Cancer - Category: Cancer & Oncology Authors: Tags: CASE REPORT Source Type: research