Abstract / Description of output
Objective: NA
Background: The optimal initial diagnostic approach to suspected occult cancer as a cause following an acute ischemic stroke (AIS) of undetermined origin remains unknown. Positron emission tomography combined with computed tomography (PET/CT) may play a role as the initial imaging modality in cases of suspected occult cancer.
Design/Methods: NA
Results: A 77-year-old woman presented with a non-lacunar left temporal AIS. The initial stroke work-up did not show large artery disease or a cardioembolic source. An unexplained mild normocytic anemia and a slightly elevated C-reactive protein were noted. An occult cancer was suspected, and a PET/CT demonstrated an abdominal mass which was later found to be a stage III (T3N1M0), low-grade adenocarcinoma. A stage I, low-grade urothelial bladder carcinoma was also noted on contrast-enhanced abdominal CT-scan. Both cancers were surgically treated and the patient remained functionally independent after a 3-year follow-up, without any further ischemic events or other identified causes of stroke.
Conclusions: To our knowledge, this is a unique report of a patient with an AIS in which a suspected occult cancer was identified using PET/CT. This case study demonstrates the importance of considering an occult cancer in the differential of an AIS etiology and highlights possible clinical and laboratory clues that should prompt investigations. PET/CT may allow a better detection and distinction of suspect mass lesions as compared to standard CT-scan, as it offers a functional evaluation in addition to anatomical findings.
Background: The optimal initial diagnostic approach to suspected occult cancer as a cause following an acute ischemic stroke (AIS) of undetermined origin remains unknown. Positron emission tomography combined with computed tomography (PET/CT) may play a role as the initial imaging modality in cases of suspected occult cancer.
Design/Methods: NA
Results: A 77-year-old woman presented with a non-lacunar left temporal AIS. The initial stroke work-up did not show large artery disease or a cardioembolic source. An unexplained mild normocytic anemia and a slightly elevated C-reactive protein were noted. An occult cancer was suspected, and a PET/CT demonstrated an abdominal mass which was later found to be a stage III (T3N1M0), low-grade adenocarcinoma. A stage I, low-grade urothelial bladder carcinoma was also noted on contrast-enhanced abdominal CT-scan. Both cancers were surgically treated and the patient remained functionally independent after a 3-year follow-up, without any further ischemic events or other identified causes of stroke.
Conclusions: To our knowledge, this is a unique report of a patient with an AIS in which a suspected occult cancer was identified using PET/CT. This case study demonstrates the importance of considering an occult cancer in the differential of an AIS etiology and highlights possible clinical and laboratory clues that should prompt investigations. PET/CT may allow a better detection and distinction of suspect mass lesions as compared to standard CT-scan, as it offers a functional evaluation in addition to anatomical findings.
| Original language | English |
|---|---|
| Article number | 578 |
| Journal | Neurology |
| Volume | 94 |
| Issue number | 15 Supplement |
| Publication status | Published - 14 Apr 2020 |