Stroke and a valvular lesion in a patient with stage IV non-small cell lung cancer

Authors

Angel A. Mitma, Department of Internal Medicine, Bridgeport Hospital, Bridgeport, Connecticut, USA Yale University School of Medicine, New Haven, Connecticut, USA.
Jithin G. Varghese, Department of Internal Medicine, Bridgeport Hospital, Bridgeport, Connecticut, USA.
David Witt, Yale University School of Medicine, New Haven, Connecticut, USA Yale Smilow Cancer Hospital, New Haven, Connecticut, USA.
Stuart W. Zarich, Yale University School of Medicine, New Haven, Connecticut, USA Department of Cardiology, Bridgeport Hospital, Bridgeport, Connecticut, USA.

Document Type

Article

Publication Title

BMJ case reports

Abstract

The mechanism and severity of stroke varies in the setting of malignancy. We report a case of a 68-year-old man with lung adenocarcinoma, who experienced acute neurological symptoms. Imaging studies showed multiple acute ischaemic infarcts in cerebral and cerebellar hemispheres. Further work up was consistent with non-bacterial thrombotic endocarditis (NBTE). We highlight, through a review of the literature, the importance of transoesophageal echocardiography (TOE) in defining the above diagnosis. The treatment of NBTE consists of systemic anticoagulation and therapy of the underlying malignancy. Enoxaparin is preferred over warfarin to achieve this goal. He received systemic targeted therapy with erlotinib. A TOE performed 8 months later showed complete resolution of the vegetation.

DOI

10.1136/bcr-2016-215317

Publication Date

5-31-2016

Recommended Citation

Mitma, Angel A.; Varghese, Jithin G.; Witt, David; and Zarich, Stuart W., "Stroke and a valvular lesion in a patient with stage IV non-small cell lung cancer" (2016). Cardiology. 14.
https://scholar.bridgeporthospital.org/cardiology/14

Identifier

27247207 (pubmed); PMC4904385 (pmc); 10.1136/bcr-2016-215317 (doi); bcr-2016-215317 (pii)