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: December 25, 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 December 25, 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