Aoki Ryo, Kato Shingo, Nakajima Kento, Sakai Jun, Yoshida Kenichi, Masui Hidenori, Ikeda Shin, Yoshigi Jun, Utsunomiya Daisuke
Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Department of Surgery, Yokosuka Kyosai Hospital, Yokosuka, Japan.
BJR Case Rep. 2023 Sep 12;9(5):20220149. doi: 10.1259/bjrcr.20220149. eCollection 2023 Oct.
Cardiovascular complications of cancer therapy are among the most important factors affecting cancer prognosis. Cisplatin-induced aortic thrombosis is rare but can be life-threatening in the event of peripheral embolism. In this report, we describe a case of superior mesenteric artery (SMA) embolism associated with cisplatin-induced aortic thrombosis. A 66-year-old male, diagnosed with esophageal cancer, initiated systemic chemotherapy with a regimen consisting of 5-fluorouracil and cisplatin, combined with radiotherapy. After 7 days of chemoradiotherapy, the patient developed a floating thrombus in the ascending aorta and an SMA embolism; chemoradiotherapy was then discontinued. Laparoscopy revealed an ischemic small intestine that required resection; intravenous unfractionated heparin was initiated 3 days after. Computed tomography showed disappearance of the floating aortic thrombus and reduce SMA thrombus size. Early detection of cisplatin-induced aortic thrombosis may prevent fatal outcomes in symptomatic peripheral embolisms, such as SMA embolism, considering anticoagulation, and discontinuation of cisplatin-based chemotherapy may cause resolution of thrombus events.
癌症治疗的心血管并发症是影响癌症预后的最重要因素之一。顺铂诱导的主动脉血栓形成罕见，但在外周栓塞时可能危及生命。在本报告中，我们描述了一例与顺铂诱导的主动脉血栓形成相关的肠系膜上动脉（SMA）栓塞病例。一名66岁男性，被诊断为食管癌，开始采用由5-氟尿嘧啶和顺铂组成的方案进行全身化疗，并联合放疗。放化疗7天后，患者升主动脉出现漂浮血栓及SMA栓塞；随后停止放化疗。腹腔镜检查发现缺血性小肠需要切除；3天后开始静脉输注普通肝素。计算机断层扫描显示漂浮的主动脉血栓消失，SMA血栓大小减小。考虑到抗凝治疗，早期发现顺铂诱导的主动脉血栓形成可能预防有症状的外周栓塞（如SMA栓塞）的致命后果，停用基于顺铂的化疗可能使血栓事件消退。
