Lung adenocarcinoma complicated by Trousseau’s syndrome successfully treated by a combination of anticoagulant therapy and chemotherapy

Abstract

A 63-year-old woman was diagnosed with advanced lung adenocarcinoma complicated by Trousseau’s syndrome characterized by non-bacterial thrombotic endocarditis, asymptomatic brain infarction, deep venous thrombosis, and low-grade disseminated intravascular coagulation (DIC). The patient’s DIC rapidly became widespread, and multiple micropulmonary embolisms led to severe respiratory failure. She received a blood transfusion and anticoagulant treatment with heparin and recombinant human soluble thrombomodulin, which modestly ameliorated her symptoms, and additional chemotherapy led to tumor shrinkage with concomitant resolution of Trousseau’s syndrome. Although there are no established medical approaches for managing Trousseau’s syndrome, intensive anticoagulant treatment may be effective for improving the patients’ general condition in order for them to be able to undergo subsequent combination chemotherapy.