Prostate cancer-associated Trousseau's syndrome presenting as stroke in a 42-year-old man.
This case highlights the need to consider prostate cancer as a potential cause of stroke in younger patients and the importance of monitoring thrombotic markers.
Where it sits
this study against the rest of the degarelix corpusSummary and findings
This case report describes a 42-year-old man who experienced acute left hemiparesis and multiple cerebral infarctions, with elevated D-dimer levels. He was later diagnosed with advanced prostate adenocarcinoma and treated with apalutamide and degarelix. Over 10 months, PSA and D-dimer levels decreased significantly, and no further thromboembolic events were reported.
Abstract
We report a 42-year-old man presenting with acute left hemiparesis and multiple cerebral infarctions accompanied by markedly elevated D-dimer levels, suggesting cancer-associated thrombosis without an identifiable primary malignancy. Six months later, he was diagnosed with advanced prostate adenocarcinoma with multiple bone metastases and a markedly elevated prostate-specific antigen level. Treatment with apalutamide and degarelix was initiated. Despite early recurrent thromboembolic events, PSA and D-dimer levels gradually decreased. At 10 months, both markers were significantly reduced and no further thrombosis occurred. This case highlights prostate cancer as a potential cause of cryptogenic stroke and importance of cancer-directed therapy for Trousseau's syndrome.
Background
This paper addresses the clinical presentation of Trousseau's syndrome in the context of prostate cancer, which is known to be associated with thromboembolic events. Prior literature has established a link between malignancies and increased thrombotic risk, but the specific presentation as stroke in younger patients is less documented. Understanding this connection is vital for timely diagnosis and management of similar cases.
Methods
This is a case report detailing the clinical course of a single patient. The patient was a 42-year-old man diagnosed with advanced prostate adenocarcinoma after presenting with stroke symptoms. Treatment included apalutamide and degarelix, with follow-up over a period of 10 months to monitor PSA and D-dimer levels.
Results
At 10 months, both PSA and D-dimer levels were significantly reduced, although exact numeric values were not provided. The patient experienced no further thromboembolic events during this period.
Interpretation
The findings suggest a potential link between prostate cancer and cryptogenic stroke, supporting the need for cancer-directed therapy in such cases. However, the lack of control and the single-case nature of the report limit the strength of the conclusions. The clinical significance of the observed reductions in PSA and D-dimer levels remains unclear without comparative data.
Key findings
- D-dimer levels markedly elevated at presentation.
- PSA level significantly elevated at diagnosis.
- D-dimer levels gradually decreased over 10 months.
- No further thrombosis occurred after 10 months.
Limitations
- Single case report with no control group.
- Lack of detailed numeric findings for PSA and D-dimer levels.
- Short follow-up duration for assessing long-term outcomes.