Acute Concurrent Cardiocerebral Infarction Associated With Trousseau Syndrome: A Case Report

TL;DR

A 66-year-old woman with uterine cancer developed simultaneous heart and brain infarctions due to Trousseau syndrome, a rare cancer-related blood clotting disorder.

Contribution

This is the first reported case of Trousseau syndrome associated with stage IB uterine cancer and acute cardiocerebral infarction.

Findings

The patient had multiple cerebral infarctions and an asymptomatic myocardial infarction linked to Trousseau syndrome.

Treatment with anticoagulation and chemotherapy led to favorable recovery without further thrombotic events.

The case emphasizes the need to screen for asymptomatic heart attacks in patients with multiple strokes.

Abstract

This case report describes a 66-year-old woman presenting with acute aphasia and right hemiplegia caused by multiple cerebral infarctions. Diagnostic evaluation confirmed an asymptomatic myocardial infarction (MI), as evidenced by elevated troponin I levels (3.1 ng/mL); ST-segment elevation in leads II, III, and aVF on electrocardiography; and coronary angiography showing a thrombotic occlusion in the distal portion of the left anterior descending artery. Elevated tumor markers and imaging identified stage IB endometrioid uterine carcinoma. She had a malignant tumor and multiple thrombotic events and was diagnosed with Trousseau syndrome. Management involved hysterectomy with bilateral salpingo-oophorectomy followed by chemotherapy and anticoagulation therapy, initiated with heparin and transitioned to apixaban due to the desire to minimize impact on the quality of life by using an oral medication. The patient achieved a favorable recovery without recurrent thrombotic events. To the best of our knowledge, this is the first report of a patient with Trousseau syndrome associated with stage IB uterine cancer developing acute cardiocerebral infarction (CCI). This case highlights the importance of identifying Trousseau syndrome in patients with multiple cerebral infarctions and underscores the need to screen for and asymptomatic MI, even in the absence of cardiac symptoms.

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