CT-Proven Ischaemic Stroke as the First Manifestation of Occult Lung Cancer

Authors

• João Azeredo Costa Internal Medicine Service 1.2, Hospital de São José, Centro Hospitalar Universitário Lisboa Central, E.P.E., Lisbon, Portugal
• Mário Rodrigues Internal Medicine Service 1.2, Hospital de São José, Centro Hospitalar Universitário Lisboa Central, E.P.E., Lisbon, Portugal
• Manuel Monteiro Internal Medicine Service 1.2, Hospital de São José, Centro Hospitalar Universitário Lisboa Central, E.P.E., Lisbon, Portugal
• Vera Salvado Internal Medicine Service 1.2, Hospital de São José, Centro Hospitalar Universitário Lisboa Central, E.P.E., Lisbon, Portugal
• Luis Dias Internal Medicine Service 1.2, Hospital de São José, Centro Hospitalar Universitário Lisboa Central, E.P.E., Lisbon, Portugal

j.azeredo.costa@gmail.com

Keywords

Abstract

Cancer is associated with a higher risk of stroke, and in rare cases stroke can be the first manifestation of occult neoplasia. We present the case of a 74-year-old woman hospitalized for ischaemic stroke with multiple cerebral infarctions in several vascular territories. The exclusion of other aetiologies and the simultaneous presence of thromboembolic events in other organs raised the suspicion of a hypercoagulable state, which upon investigation revealed occult neoplasia of the lung. There was rapid deterioration, with recurrent thrombotic events despite anticoagulation, which eventually led to the patient’s death.