Key result
Metastatic pancreatic cancer presents with catastrophic simultaneous arterial and venous thromboembolism.
Why the study?
Simultaneous arterial and venous thromboses affecting multiple organs at the time of initial pancreatic cancer diagnosis is rare, with an incidence of less than 1%.
Case Report (n=1)
Simultaneous arterial and venous thromboses affecting multiple organs can be a rare initial presentation of metastatic pancreatic cancer.
Simultaneous multi-territory arterial-venous thromboses may herald occult malignancy; extends paraneoplastic thrombosis spectrum but remains hypothesis-generating.
CONTEXT: The association between cancer and thrombosis is well-known. Among gastrointestinal malignancies, pancreatic cancer has perhaps the strongest association with thromboembolic events. However, simultaneous arterial and venous thromboses affecting multiple organs at the time of initial diagnosis is rare, with an incidence of less than 1%. CASE REPORT: We report herein a case of a 61-year-old woman who presented with digital ischemia, a non-ST elevation myocardial infarction and an ischemic stroke, along with deep vein thromboses and pulmonary embolism. She was subsequently diagnosed with metastatic pancreatic cancer. DISCUSSION: This report highlights the intriguing association between pancreatic cancer biology, tumor metastases, and triggering of venous and arterial thromboembolic events. Current evidence points towards early thromboembolic phenomena as a harbinger of poor outcome in pancreatic cancer, and studies attempting to define the role of prophylactic anticoagulation in these patients are ongoing.
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Majumder et al. (2012) conducted a case report in Metastatic pancreatic cancer with catastrophic arteriovenous thromboembolism (n=1). Metastatic pancreatic cancer was evaluated on Simultaneous arterial and venous thromboses (digital ischemia, NSTEMI, ischemic stroke, DVT, PE). A 61-year-old woman presented with catastrophic simultaneous arterial and venous thromboembolism, including NSTEMI, stroke, DVT, and PE, as the initial manifestation of metastatic pancreatic cancer.
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