SESSION TITLE: Cancer Case Report Posters I
SESSION TYPE: Case Report Poster
PRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PM
INTRODUCTION: Pulmonary embolism is often associated With cancer in high prevalence. This diagnostic must not be Forget When we manage PE
CASE PRESENTATION: Man of 61 year old, tarde commissionner présented in emergency département for subacute progressive dyspnea and pain int left hemithorax. The patient is under antibiotics(levofloxacin and fluconazole) for a so called laryngitis. No other complaint is raised. Médical and surgical history is common place. He have as cardiovascular risk: hypercholestérolémia,glucose intolerance, and an estimade 40 units pack-year smoking history.no abnomarmalitie was found in clinical examination.
DISCUSSION: In the management of this patient , additionnal assesement is then Carried out to exclude aPulmonary infection, Pulmonary embolism , pneumothorax and myocardical infraction . Vendus blood show the Ddimer at 19.353 mg/l. Chest x-Ray reveal a diffuse Began micronodular syndrom in both lung fields. A doppler imaging showed a femoral vein thrombosis in deep and superficial Line . And a thoracic angioscan confirmed a PEin the lower right pulmonary. We see also many medaistinal lymphadenopathy, basi cervical and subcarina. Highly suspicions of sarcoidosis, a bronchoscopy with biospy and transcarina biopsy reveal poorly différentiated lung carcinoma. Immunohistochemical confirmed this . The extension of neoplastic involvement show metastic diffusion in liver and bone( the entier spin). Blood sample reveal an hyponatremia, and hypocalcemia as paraneoplastic comlpication. The patient was categorized as stage 4( t4 n3 m1)The patient was more confuse for a short Time. Patient reiceived chemotherapy Alone with a poor tolerance. À reiceived a 2nd chemotherapy but we stopped treatment bécause he presented a generalised seizure without prooved Brain métastasis.
CONCLUSIONS: We must not misdiagnose carcinoma in front of PE even if There are risk factor of embolism. All exam must be performed to rule out all other hypothesis in the origin of this embolism. we must consider smoker status and age
Reference #1: Incident of PE in cancer patient . Clinical caractéristic and out comes. Vasc . Health Risk. Management 2011. 7153-58
Reference #2: Management of unsuspected PE in cancer patients J Trujillo Santos and al. . Expert Review of Hematology
DISCLOSURE: The following authors have nothing to disclose: Dominique Butenda, Pierre Duysinx
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