Rao Ruiying, Lin Ping, Xu Jinhe, Wang Chenxi, Chen Ying, Ito Shinji, Mutoh Tatsuro, Yu Zongyang
Department of Respiratory and Critical Care Medicine, Fuzong Teaching Hospital, Fujian University of Traditional Chinese Medicine (900 Hospital), Fuzhou, China.
Department of Respiratory and Critical Care Medicine, The 900th Hospital of the Joint Logistic Support Force, People's Liberation Army of China, Fuzhou, China.
J Thorac Dis. 2024 Sep 30;16(9):6249-6262. doi: 10.21037/jtd-24-1232. Epub 2024 Sep 26.
Trousseau syndrome (TS) refers to spontaneous, recurrent, and wandering arterial and venous thromboembolic events in patients with tumors. It results from abnormalities in coagulation and fibrinolytic mechanisms of varying degrees throughout the course of the disease. It has a high fatality rate, and it is commonly seen in patients with highly invasive tumors, such as lung, pancreatic, gastrointestinal, and breast cancers; however, to date, there has been no report of TS combined with chordoma.
A 56-year-old male with a diagnosis of chordoma underwent surgery, immunotherapy, immunotherapy combined with antiangiogenic therapy, chemotherapy combined with immunotherapy, and proton therapy for localized metastases. Subsequent to the worsening of chest tightness, a repeat chest computed tomography angiography (CTA) scan suggested pulmonary artery embolisms; eventually, a diagnosis of TS was made. After anticoagulation and synchronized antitumor therapy, the patient's condition remained recurrent, eventually leading to death.
TS is a frequent but easily overlooked clinical complication that can occur in a variety of tumors, including chordoma, and is currently diagnosed clinically. Thus, further exploration of its sensitive markers is needed. We have reported a case of chordoma combined with TS and conducted a literature review on TS to increase clinicians' awareness of tumor-related thromboembolism and explore strategies to optimize the diagnosis, treatment, and prevention of TS.
Trousseau综合征(TS)是指肿瘤患者发生的自发性、复发性及游走性动静脉血栓栓塞事件。在疾病的整个过程中,它是由不同程度的凝血和纤溶机制异常导致的。其病死率高,常见于具有高度侵袭性的肿瘤患者,如肺癌、胰腺癌、胃肠道癌和乳腺癌;然而,迄今为止,尚无TS合并脊索瘤的报道。
一名56岁男性,诊断为脊索瘤,接受了手术、免疫治疗、免疫治疗联合抗血管生成治疗、化疗联合免疫治疗以及针对局部转移灶的质子治疗。在胸闷症状加重后,重复胸部计算机断层血管造影(CTA)扫描提示肺动脉栓塞;最终确诊为TS。经过抗凝和同步抗肿瘤治疗后,患者病情仍反复,最终导致死亡。
TS是一种常见但易被忽视的临床并发症,可发生于包括脊索瘤在内的多种肿瘤中,目前依靠临床诊断。因此,需要进一步探索其敏感标志物。我们报告了一例脊索瘤合并TS的病例,并对TS进行了文献综述,以提高临床医生对肿瘤相关血栓栓塞的认识,并探索优化TS诊断、治疗和预防的策略。