Useful anticoagulation therapy with heparin for Trousseau's syndrome in a terminally ill patient with rectal cancer： A case report

ABSTRACT

Trousseau syndrome is a clinical condition in which a thrombosis and embolism are caused by hypercoagulation associated with a malignant tumor. Here we report on a patient who developed a cerebral infarction during hospitalization in a palliative care unit due to advanced recurrent rectal cancer and was treated with anticoagulation therapy. A 50—year—old woman who experienced lung metastasis and bone metastases after rectal cancer surgery was hospitalized in a palliative care unit because increasing pain made home care difficult. Although her pain was relieved by drug therapy and irradiation, she developed a partial visual field defect and aphasia in succession when she received medical treatment because of respiratory discomfort due to advanced pulmonary metastases. Multiple cerebral infarctions were observed on a magnetic resonance imaging and blood tests revealed disseminated intravascular coagulation； therefore she was diagnosed with Trousseau syndrome. After the initiation of anticoagulation therapy, the aphasia improved. No adverse events were caused by treatment. All patients in the terminal phase should not be equally judged as not being candidates for anticoagulation therapy. It is necessary to examine each patient’s suitability by considering their prognosis and general condition as well as the significance and safety of the treatment.