Cerebral Infarction Developing in A Patient Without Cancer With A Markedly Elevated Level of Mucinous Tumor Marker

Yamashiro, Kazuo; Furuya, Tsuyoshi; Noda, Kazuyuki; Urabe, Takao; Okuma, Yasuyuki

doi:10.1016/j.jstrokecerebrovasdis.2010.12.007

Cited by 17 publications

(15 citation statements)

References 9 publications

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“…Another factor is elevated CA125. CA125 is a typical mucin molecule, which can activate the coagulation system by activating factor X. CA125 is considered as a susceptible factor for non-bacterial thrombotic endocarditis and disseminated thrombosis [11]. Besides, another factor is anemia.…”

Section: Discussionmentioning

confidence: 99%

Acute cerebral infarction with adenomyosis in a patient with fever: a case report

2020

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Background: It is reported that acute cerebral infarction with adenomyosis is associated with elevated D-Dimer, elevated CA125, anemia and menstruation. However, previous reports did not notice infection known as fever, which may be a potential risk factor for developing acute cerebral infarction with adenomyosis. Case presentation: We describe a 34-year-old woman who presented headache and fever (38°C) for 4 days and left limb weakness for 1 day during her menstrual phase. Laboratory test data showed: Hemoglobin (HGB) (112 g/L, normal: 120-150 g/L), Carcinoembryonic antigen 125 (CA125) (937.70 U/ml, normal: 0-35 U/ml), D-Dimer (27.4 mg/L, normal: 0-1.5 mg/L). Magnetic resonance imaging (MRI) indicated acute cerebral infarction in right basal ganglia and subcortical region of right frontotemporal lobe. Further, brain computed tomography angiography (CTA) showed that the M1 segment of right middle cerebral artery was strictured and the distal branches of right middle cerebral artery were significantly less than those on the opposite side. No obvious abnormality was found in cranial magnetic resonance venogram (MRV). She had a 5-year history of adenomyosis. No tumors were found by whole body positron emission tomography-computed tomography (PET-CT). We treated this patient by using antiinfective therapy for 1 week and using anticoagulant therapy with low molecular weight heparin for 2 weeks. Subsequently, the anticoagulant therapy was discontinued and replaced by antiplatelet therapy with clopidogrel. We followed up this patient for 4 months, and no recurrence of cerebral infarction was found. Conclusions: Acute cerebral infarction with adenomyosis may be related to elevated D-Dimer, elevated CA125, anemia and menstruation. Our report suggests that infection may be a potential risk factor for developing acute cerebral infarction with adenomyosis.

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Section: Discussionmentioning

confidence: 99%

Acute cerebral infarction with adenomyosis in a patient with fever: a case report

2020

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“…Partially purified mucin can activate the coagulation system by activating factor X. Circulating mucus produced by cancer is considered as a susceptible factor for non-bacterial thrombotic endocarditis and disseminated thrombosis [11]. Recent experimental studies showed that carcinoma mucins promote thrombosis through the adhesion of neutrophils and platelets dependent on bidirectional signals [12].…”

Section: Discussionmentioning

confidence: 99%

Acute cerebral infarction with adenomyosis in a young woman: a case report

Zhao

Zhang

Yang

2019

Preprint

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Background Acute cerebral infarction with adenomyosis in a young woman has been rarely reported. Case presentation We describe a 34-year-old young woman who presented headache and fever (38°C) for 4 days and left limb weakness for 1 day during her menstrual phase. Laboratory test data showed: Hemoglobin (HGB) (112g/L, normal: 120-150 g/L), Carcinoembryonic antigen 125 (CA125) (937.70U/ml, normal: 0-35 U/ml), D-Dimer (27.4mg/L, normal: 0-1.5mg/L). Magnetic resonance imaging (MRI) indicated acute cerebral infarction in right basal ganglia and subcortical region of right frontotemporal lobe. Further, brain computed tomography angiography (CTA) showed that the M1 segment of right middle cerebral artery was strictured and the distal branches of right middle cerebral artery were significantly less than those on the opposite side. No obvious abnormality was found in cranial magnetic resonance venogram (MRV). She had a 5-year history of adenomyosis. No tumors were found by whole body positron emission tomography-computed tomography (PET-CT). We treated this patient by using anti-infective therapy for 1 week and using anticoagulant therapy with low molecular weight heparin for 2 weeks. Subsequently, the anticoagulant therapy was discontinued and replaced by antiplatelet therapy with poliovir. We followed up this patient for 4 months, and no recurrence of cerebral infarction was found. Conclusions Acute cerebral infarction with adenomyosis may be related to elevated D-Dimer, elevated CA125, anemia, menstruation and fever. Our report suggests that acute cerebral infarction with adenomyosis can occur not only in middle-aged women but also in young women, and fever during menstrual phase in a woman with adenomyosis may be a factor leading to acute cerebral infarction.

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“…However, side effects restrict the administration period of a GnRH agonist, and there is a report of a patient (Case No. 4 in Table 1 ) who had recurrent ischemic stroke after discontinuation of a GnRH agonist [ 8 , 9 ]. Antithrombotic drugs are another treatment option.…”

Section: Discussionmentioning

confidence: 99%

Cerebral infarction associated with benign mucin-producing adenomyosis: report of two cases

et al. 2018

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BackgroundCerebral infarction associated with a malignant tumor is widely recognized as Trousseau syndrome. In contrast, few cases of cerebral infarction associated with benign tumors have been reported. We present two cases of embolic stroke that seemed to be caused by mucin-producing adenomyosis.Case presentationThe patients were women aged 42 and 50 years old. Both patients developed right hemiparesis and aphasia, and cerebral infarctions were detected in the left cerebral hemisphere. There were no other abnormal findings, except for elevation of CA125 and D-dimer. Trousseau syndrome was suspected in both cases, but whole body examinations did not reveal any malignant tumors. However, uterine adenomyosis was detected in both patients.ConclusionsFrom our findings and a review of the literature, both mucin-producing malignant tumors and mucin-producing benign tumors such as adenomyosis may cause hypercoagulability and cerebral infarction. This mechanism should be considered in a case of a young to middle-aged woman with embolic stroke of an undetermined origin.

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Cerebral Infarction Developing in A Patient Without Cancer With A Markedly Elevated Level of Mucinous Tumor Marker

Cited by 17 publications

References 9 publications

Acute cerebral infarction with adenomyosis in a patient with fever: a case report

Acute cerebral infarction with adenomyosis in a patient with fever: a case report

Acute cerebral infarction with adenomyosis in a young woman: a case report

Cerebral infarction associated with benign mucin-producing adenomyosis: report of two cases

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