Case Report

Volume: 8 | Issue: 6 | Published: May 11, 2024 | Pages: 113 - 117 | DOI: 10.24911/ejmcr.173-1641049029

Pancreatic cancer with multiple liver metastasis complicating multi organ infarcts from Marantic endocarditis and Trousseau's syndrome


Authors: Mir Rahman , Alan Wiles , Raj Shekhar


Article Info

Authors

Mir Rahman

IMT 3 trainee, Queen Elizabeth Hospital, King's Lynn, Norfolk, United Kingdom

Alan Wiles

Gastroenterology consultant, Queen Elizabeth Hospital, King's Lynn, Norfolk, United Kingdom

Raj Shekhar

Stroke consultant, Queen Elizabeth Hospital, King's Lynn, Norfolk, United Kingdom.

Publication History

Received: February 10, 2022

Accepted:

Published: May 11, 2024


Abstract


Background: Marantic endocarditis and Trousseau's syndrome are historically linked with pancreatic cancer. The patient had catastrophic embolic events which caused multi organ infarct due to underlying advanced pancreatic cancer. Doctors should be aware of early signs and symptoms of pancreatic cancer and conduct necessary clinical assessments and investigations that can prevent any severe complications. Case Presentation: A middle-aged healthy gentleman who presented with left-sided weakness, slurred speech, left-sided sensory neglect, mild headache, and fever. CT head showed acute right-sided temporal ischemic changes with subsequent magnetic resonance imaging (MRI) head showed multiple infarcts in the brain. A transesophageal echocardiogram reported possible MV vegetation. MRI of the liver was done due to deranged LFTs which showed multiple liver metastasis with a primary mass in the tail of the pancreas. Left leg ultrasound Doppler showed a large left leg deep vein thrombosis involving the femoral vein as he complained of left leg pain for 2 months and went to GP with right leg pain 3 months ago which was treated as a right ankle sprain. The clinical events explained that most likely he developed Trousseau's syndrome 3 months ago and the embolic phenomena were due to rare Marantic endocarditis (Non-bacterial thrombotic endocarditis) secondary to pancreatic cancer. Ultrasound-guided biopsy of liver metastasis was planned, but sadly the patient passed away the next day. Conclusion: The diagnosis of early pancreatic cancer with imaging poses a challenge sometimes, therefore the pancreatic protocol of CT or MRI is the first line of investigation. Moreover, the cause of unprovoked thrombo-embolism should be investigated to rule out any underlying malignancy.

Keywords: Pancreatic cancer, Marantic Endocarditis, Trousseau's syndrome, green


Pubmed Style

Mir Rahman, Alan Wiles, Raj Shekhar. Pancreatic cancer with multiple liver metastasis complicating multi organ infarcts from Marantic endocarditis and Trousseau's syndrome. EJMCR. 2024; 11 (May 2024): 113-117. doi:10.24911/ejmcr.173-1641049029

Web Style

Mir Rahman, Alan Wiles, Raj Shekhar. Pancreatic cancer with multiple liver metastasis complicating multi organ infarcts from Marantic endocarditis and Trousseau's syndrome. https://ejmcr.com/articles/1215 [Access: November 23, 2024]. doi:10.24911/ejmcr.173-1641049029

AMA (American Medical Association) Style

Mir Rahman, Alan Wiles, Raj Shekhar. Pancreatic cancer with multiple liver metastasis complicating multi organ infarcts from Marantic endocarditis and Trousseau's syndrome. EJMCR. 2024; 11 (May 2024): 113-117. doi:10.24911/ejmcr.173-1641049029

Vancouver/ICMJE Style

Mir Rahman, Alan Wiles, Raj Shekhar. Pancreatic cancer with multiple liver metastasis complicating multi organ infarcts from Marantic endocarditis and Trousseau's syndrome. EJMCR. (2024), [cited November 23, 2024]; 11 (May 2024): 113-117. doi:10.24911/ejmcr.173-1641049029

Harvard Style

Mir Rahman, Alan Wiles, Raj Shekhar (2024) Pancreatic cancer with multiple liver metastasis complicating multi organ infarcts from Marantic endocarditis and Trousseau's syndrome. EJMCR, 11 (May 2024): 113-117. doi:10.24911/ejmcr.173-1641049029

Chicago Style

Mir Rahman, Alan Wiles, Raj Shekhar. "Pancreatic cancer with multiple liver metastasis complicating multi organ infarcts from Marantic endocarditis and Trousseau's syndrome." 11 (2024), 113-117. doi:10.24911/ejmcr.173-1641049029

MLA (The Modern Language Association) Style

Mir Rahman, Alan Wiles, Raj Shekhar. "Pancreatic cancer with multiple liver metastasis complicating multi organ infarcts from Marantic endocarditis and Trousseau's syndrome." 11.May 2024 (2024), 113-117. Print. doi:10.24911/ejmcr.173-1641049029

APA (American Psychological Association) Style

Mir Rahman, Alan Wiles, Raj Shekhar (2024) Pancreatic cancer with multiple liver metastasis complicating multi organ infarcts from Marantic endocarditis and Trousseau's syndrome. , 11 (May 2024), 113-117. doi:10.24911/ejmcr.173-1641049029