Cancer-related multiple brain infarctions caused by Trousseau syndrome in a patient with metastatic colon cancer: a case report

Abstract

Thromboembolism that occurs in association with a malignant tumor is known as Trousseau syndrome. We herein present a case of Trousseau syndrome during systemic chemotherapy for metastatic colon cancer. A 65-year-old man with multiple liver metastases underwent primary tumor resection and systemic chemotherapy. Multiple brain infarctions were detected by magnetic resonance imaging immediately after first-line chemotherapy, which was deemed ineffective. There was no evidence of cardioembolic stroke or carotid atherosclerosis. Although the patient was initially asymptomatic, he subsequently developed paralysis. Despite anticoagulant treatment, he developed repeated recurrences of the infarction, and the area of the infarction spread as the liver metastases progressed. The patient's condition showed no response to an alternative treatment regimen for advanced colon carcinoma. He died approximately 11 months after tumor discovery.

Keywords: Brain infarction; Hypercoagulability; Metastatic colorectal cancer; Trousseau syndrome.

Fig. 1

Gadoxetic acid (Gd-EOB-DTPA)-enhanced MRI for detection of liver metastases showed multiple liver metastases before chemotherapy

Fig. 2

Brain and carotid artery magnetic resonance angiography showed that the main vessels were normal

Fig. 3

Brain MRI (diffusion-weighted) shows multiple small brain infarctions

Fig. 4

Clinical course of the patient’s laboratory data, enhanced CT for detection of liver metastases, brain MRI for detection of infarctions, anticoagulant therapies, and anticancer therapies. Cmab + SOX cetuximab, oxaliplatin, and S-1 therapy, IRIS irinotecan and S-1