Cancer-associated stroke from progressive acinic cell carcinoma.
Jao Jarro Borromeo GarciaJose Leonard Vr PascualPublished in: BMJ case reports (2024)
Cancer-associated stroke is an evolving subgroup of embolic strokes of undetermined source. A man in his mid-20s with progressive follicular variant acinic cell carcinoma of the parotid was admitted because of new onset left-sided weakness. Neuroimaging confirmed a right middle cerebral artery infarction. After extensive diagnostics, stroke aetiology was deemed from cancer-induced hypercoagulability. Questions which arose regarding his management included (1) What was the best antithrombotic for secondary stroke prevention? (2) What was his risk for intracranial or tumorous bleeding once antithrombotics had been started? (3) How many days post-stroke could the antithrombotic be initiated? and (4) When could he be cleared for palliative chemotherapy and whole brain irradiation? The approach to address the abovementioned questions in the management of a rare cancer complicated by stroke is presented. Although treatments are guided by known pathomechanisms, additional studies are needed to further support current treatment strategies for this subgroup of patients.
Keyphrases
- atrial fibrillation
- middle cerebral artery
- papillary thyroid
- multiple sclerosis
- end stage renal disease
- chronic kidney disease
- clinical trial
- randomized controlled trial
- peritoneal dialysis
- oxidative stress
- squamous cell carcinoma
- radiation therapy
- white matter
- internal carotid artery
- brain injury
- young adults
- resting state
- functional connectivity
- optical coherence tomography
- double blind