Acute Cerebral Infarction during Combination Chemotherapy with S-1 and Cisplatin for a Young Patient with a Mucin-Producing Adenocarcinoma of the Stomach

Shinya Ohashi; Shujiro Yazumi; Akiyoshi Nishio; Toshiro Fukui; Masanori Asada; Tsutomu Chiba

doi:10.2169/internalmedicine.45.1720

CASE REPORTS

Acute Cerebral Infarction during Combination Chemotherapy with S-1 and Cisplatin for a Young Patient with a Mucin-Producing Adenocarcinoma of the Stomach

Shinya Ohashi, Shujiro Yazumi, Akiyoshi Nishio, Toshiro Fukui, Masanori Asada, Tsutomu Chiba

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Keywords: Trousseau's syndrome, cisplatin-based chemotherapy, thromboembolism, mucin-producing adenocarcinoma, cerebral infarction

JOURNAL OPEN ACCESS

2006 Volume 45 Issue 18 Pages 1049-1053

DOI https://doi.org/10.2169/internalmedicine.45.1720

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Abstract

We report a 29-year-old woman with gastric cancer who developed Trousseau's syndrome, a malignancy-related thromboembolism, during chemotherapy. She was diagnosed with a mucin-producing adenocarcinoma of the stomach, and chemotherapy with S-1 and cisplatin was commenced. During treatment, she developed a sudden onset of right hemiplegia. Magnetic resonance imaging showed an acute cerebral infarction of the left cerebral hemisphere. The underlying pathophysiology is thought to be chronic disseminated intravascular coagulation due to mucin-producing adenocarcinomas. However, cisplatin-induced vascular toxicity and hypercoagulability caused by decreased plasma protein C activity, elevated plasma von-Willebrand factor levels, and hypomagnesemia has also been proposed to be associated with thrombogenicity.

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