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Massive cerebral infarct due to Trousseau's syndrome in gastric cancer
*For correspondence: drcamans@gmail.com
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This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.
A 27 yr old woman presented to the department of Medicine, MES Medical College, Perinthalmanna, Kerala, India, in January 2015 with sudden onset left-sided hemiplegia in the morning. She had advanced signet ring cell carcinoma of the stomach diagnosed 20 days earlier and received one cycle of chemotherapy. Her routine blood investigations were normal. Magnetic resonance imaging of brain revealed large infarct in right middle cerebral artery territory (Figs 1 & 2). Tests for antinuclear antibody and antiphospholipid antibodies were negative. Hereditary hypercoagulable states including protein C, protein S, antithrombin III deficiencies and activated protein C resistance were negative. Echocardiogram and carotid vertebral Doppler were normal. A diagnosis of cerebral infarct due to Trousseau's syndrome was made since other causes were ruled out. She was started on anticoagulants. Her hemiplegia persisted when followed up after two months. Trousseau's syndrome involves unexplained thrombotic events preceding the diagnosis of an occult visceral malignancy or with the tumour. Gastric malignancy leading to Trousseau's syndrome is rare.
