Clinical Report: Trousseau Syndrome Manifesting as Multiple Cerebral Infarcts

Overview

This case study presents a 76-year-old man with advanced gastric signet-ring cell carcinoma who developed multiple cerebral infarcts due to malignancy-associated hypercoagulability. The relationship between tumor burden and elevated D-dimer levels was highlighted.

Background

Malignancy-associated hypercoagulability is a significant contributor to thromboembolic events in cancer patients, leading to complications such as ischemic stroke. Understanding the mechanisms and management of this condition is crucial, especially in those with advanced malignancies like gastric signet-ring cell carcinoma, which has a high thromboembolic risk.

Data Highlights

No numerical data or trial data presented in the article.

Key Findings

• A 76-year-old man with advanced gastric signet-ring cell carcinoma developed acute left-sided hemiplegia due to multiple cerebral infarcts.
• Elevated D-dimer levels were observed, peaking at approximately 23.7 μg/mL during neurological deterioration.
• Anticoagulation with enoxaparin was initiated, but D-dimer levels remained elevated.
• Initiation of systemic chemotherapy with the XELOX regimen correlated with a decline in D-dimer levels and improvement in neurological deficits.
• The case illustrates the relationship between tumor burden and systemic hypercoagulability.

Clinical Implications

This case emphasizes the need for careful monitoring of coagulation markers in patients with advanced malignancies.

Conclusion

The findings from this case highlight the complexities of managing malignancy-associated hypercoagulability.

Related Resources & Content

1. Frontiers in Cardiovascular Medicine, 2026 -- Trousseau syndrome presenting with recurrent multi-territory infarctions: a case report of two patients highlighting divergent outcomes and dynamic hypercoagulability under direct oral anticoagulants and low-molecular-weight heparin
2. Frontiers in Oncology, 2026 -- Early risk stratification and temporal biomarker patterns of trousseau syndrome-related cerebral infarction in lung cancer
3. Classification & Management of Ischemic Stroke in Patients with Active Cancer - Professional Heart Daily | American Heart Association
4. Frontiers in Medicine — Case Report: Surgical management of giant hepatic cavernous haemangioma with Kasabach–Merritt syndrome in an adult
5. Frontiers in Cardiovascular Medicine — Case Report: Non-bacterial thrombotic endocarditis and multiple thrombi uncover a hidden prothrombotic mutation
6. Classification & Management of Ischemic Stroke in Patients with Active Cancer - Professional Heart Daily | American Heart Association
7. Intravenous thrombolysis in the context of stroke and cancer | Journal of Thrombosis and Thrombolysis | Springer Nature Link
8. Comparison of Antiplatelets and Anticoagulants for Secondary Stroke Prevention in Ischemic Stroke Patients with Cancer: A Meta-Analysis - PMC