Chin Justin, Migliozzi Matthew, Nguyen George, Kviatkovsky Bina, Lomiguen Christine
Department of Family Medicine, Lifelong Medical Care, Richmond, CA, USA.
Department of Family Medicine, University of Massachusetts Medical School, Fitchburg, MA, USA.
Respir Med Case Rep. 2020 Apr 23;30:101064. doi: 10.1016/j.rmcr.2020.101064. eCollection 2020.
Advanced lung cancer can have numerous extra-pulmonary complications. Due to the proximity to the heart, cardiac invasion and the subsequent seeding of the tumor into the vascular system present numerous challenges in physician team care coordination. Here we have a 55-year-old male who presented with stroke symptoms in the setting of undiagnosed advanced lung cancer complicated by direct tumor invasion into the left atria and mixed embolic showering phenomenon and thrombotic hypercoagulability. Review of both the embolic showering phenomenon and hypercoagulability will be discussed as both can result in embolic occlusion or metastatic seeding at distant sites. Fewer than ten cases of spontaneous tumor embolization resulting from lung cancer invasion of the pulmonary vein have been reported. Poor prognosis of advanced lung cancer requires delicate, yet pragmatic conversations between care teams and the patient.
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