Okazaki Koki, Oka Fumiaki, Ishihara Hideyuki, Suzuki Michiyasu
Department of Neurosurgery, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
BMC Neurol. 2018 Oct 4;18(1):166. doi: 10.1186/s12883-018-1169-2.
Cerebral 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.
The 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.
From 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.
与恶性肿瘤相关的脑梗死被广泛认为是Trousseau综合征。相比之下,与良性肿瘤相关的脑梗死病例报道较少。我们报告两例似乎由产生黏液的子宫腺肌病引起的栓塞性中风病例。
患者为42岁和50岁的女性。两名患者均出现右侧偏瘫和失语,左侧大脑半球检测到脑梗死。除CA125和D-二聚体升高外,无其他异常发现。两例均怀疑为Trousseau综合征,但全身检查未发现任何恶性肿瘤。然而,两名患者均检测出子宫腺肌病。
根据我们的研究结果并回顾文献,产生黏液的恶性肿瘤和诸如子宫腺肌病等产生黏液的良性肿瘤均可能导致高凝状态和脑梗死。对于病因不明的中青年女性栓塞性中风病例,应考虑这种机制。