Cerebral infarction with severe iron deficiency anemia due to uterine leiomyoma: a case report

Trousseau Syndrome is a type of cerebral infarction associated with malignant tumors; however, cerebral infarctions are unlikely to be associated with benign uterine tumors. In this study, we present the case of a middle-aged woman with uterine leiomyomas who developed multiple cerebral and cerebellar infarctions. The patient was treated for iron deficiency anemia and hypermenorrhea secondary to uterine leiomyomas. Laboratory tests at admission showed severe normocytic hypochromic anemia and a significantly low iron concentration without thrombocytosis. Other biochemical factors were within normal ranges. Examination revealed mild left upper limb weakness. After admission, increased levels of D-dimer and fibrin monomer complex were noted. Magnetic resonance imaging revealed an acute cortical infarction in the right motor cortex, multiple cerebral infarctions, and an old left parietal infarction. A total of 12 units of concentrated red blood cells were transfused prior to and on the day of surgery. After total hysterectomy, motor paresis gradually improved, and follow-up magnetic resonance imaging revealed no new cerebral infarctions. The patient was successfully treated and discharged without recurrence of cerebral infarction. Anemia is not commonly recognized as a risk factor for brain ischemia. However, our findings suggest that uterine leiomyomas are risk factors for brain ischemia in patients with severe anemia. Thus, we suggest a possible relationship between cerebral infarction and uterine leiomyomas.