# A Rare Triad of Pulmonary Embolism, Inferior Vena Cava Thrombosis, and Hepatic Cyst Compression Revealing Occult Non-small Cell Lung Cancer

## TL;DR

A 74-year-old woman with pulmonary embolism and other complications was found to have lung cancer, showing the need for broad differential diagnosis in complex cases.

## Contribution

Highlights a rare clinical triad linking pulmonary embolism, vena cava thrombosis, and occult lung cancer.

## Key findings

- A hepatic cyst compressing the inferior vena cava contributed to thrombus formation.
- Metastatic non-small cell lung cancer with an EGFR exon 19 deletion was diagnosed.
- The case illustrates convergence of vascular obstruction, benign mass effects, and cancer-related hypercoagulability.

## Abstract

We present the case of a 74-year-old woman who was admitted with acute shortness of breath and ultimately diagnosed with bilateral pulmonary emboli, inferior vena cava thrombosis, and a rapidly enlarging hepatic cyst. The cyst was compressing the inferior vena cava and contributing to thrombus formation. Her hospital course was further complicated by a diagnosis of metastatic non-small cell lung cancer harboring an epidermal growth factor receptor exon 19 deletion. This particular clinical scenario highlights the importance of maintaining a broad differential diagnosis when assessing pulmonary embolism, particularly in the absence of clear provoking factors. It illustrates how vascular obstruction, mass effect from benign lesions, and malignancy-associated hypercoagulability can converge to create a complex clinical picture.