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Case Reports
. 2024 Feb 28;12(3):47.
doi: 10.3390/diseases12030047.

The Conundrum of Cancer-Associated Thrombosis: Lesson Learned from Two Intriguing Cases and Literature Review

Simona Laurino  1 , Sabino Russi  1 , Ludmila Carmen Omer  2 , Alberto D'Angelo  3 , Giovanni Bozza  4 , Giuseppina Gallucci  5 , Geppino Falco  6 , Giandomenico Roviello  7 , Anna Maria Bochicchio  8
Affiliations
Case Reports

The Conundrum of Cancer-Associated Thrombosis: Lesson Learned from Two Intriguing Cases and Literature Review

Simona Laurino et al. Diseases. .

Abstract

The correlation between cancer and venous thromboembolism (VTE) is solid, whereas the knowledge about cancer-related arterial thromboembolism (ATE) still needs a deeper investigation to clarify its pathogenesis. We describe two cases that represent useful hints for a comprehensive review of the thrombotic issue. A 75-year-old man with advanced rectal cancer treated with fluoropyrimidines suffered two catheter-related VTE events managed according to current guidelines. There was no indication for "extended" anticoagulant therapy for him, but during antithrombotic wash-out and fluoropyrimidines plus panitumumab regimen, he suffered a massive right coronary artery (RCA) thrombosis. Another patient with no cardiovascular (CV) risk factors and affected by advanced bladder cancer was treated with a platinum-containing regimen and suffered an acute inferior myocardial infarction 2 days after chemotherapy administration. He was successfully treated with primary Percutaneous Transluminal Coronary Angioplasty of RCA, discontinuing platinum-based therapy. Our observations raise the issue of cancer-associated thrombosis (CAT) complexity and the potential correlation between arterial and venous thrombotic events. Moreover, physicians should be aware of the thrombotic risk associated with anticancer therapies, suggesting that an appropriate prophylaxis should be considered.

Keywords: arterial thromboembolism (ATE); cancer patients; cancer-associated thrombosis (CAT); mechanisms of thrombosis; reverse cardio-oncology; thrombophilic status of cancer patients; venous thromboembolism (VTE).

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of the data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Coronary angiography showing occlusion of the right coronary artery (arrow) (A); normal angiogram of the left coronary artery (B).
See this image and copyright information in PMC

References

    1. Trousseau A. Clinique Médicale de l’Hôtel-Dieu de Paris. Volume 1 Baillière; Paris, France: 1861.
    1. Bertoletti L., Madridano O., Jiménez D., Muriel A., Bikdeli B., Ay C., Trujillo-Santos J., Bosevski M., Sigüenza P., Monreal M. Cancer-Associated Thrombosis: Trends in Clinical Features, Treatment, and Outcomes From 2001 to 2020. JACC CardioOncol. 2023;5:758–772. doi: 10.1016/j.jaccao.2023.09.003. - DOI - PMC - PubMed
    1. Donnellan E., Khorana A.A. Cancer and venous thromboembolic disease: A review. Oncologist. 2017;22:199–207. doi: 10.1634/theoncologist.2016-0214. - DOI - PMC - PubMed
    1. Lyman G.H., Culakova E., Poniewierski M.S., Kuderer N.M. Morbidity, mortality and costs associated with venous thromboembolism in hospitalized patients with cancer. Thromb. Res. 2018;164((Suppl. S1)):S112–S118. doi: 10.1016/j.thromres.2018.01.028. - DOI - PubMed
    1. Chatani R., Yamashita Y., Morimoto T., Kaneda K., Mushiake K., Kadota K., Nishimoto Y., Ikeda N., Kobayashi Y., Ikeda S., et al. Transition of management strategies and long-term outcomes in cancer-associated venous thromboembolism from the warfarin era to the direct oral anticoagulant era. Eur. J. Intern. Med. 2024 doi: 10.1016/j.ejim.2024.01.012. - DOI - PubMed

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