Trousseau’s syndrome in a non-small cell lung cancer patient aggravated by pembrolizumab

Abstract

Introduction

We present a case of Trousseau’s syndrome in a non-small cell lung cancer patient recurrently aggravated by pembrolizumab. The adverse events related to immune checkpoint inhibitors (ICIs) on thrombogenesis remain unclear.

Case report

A 48-year-old woman was diagnosed with right lung adenocarcinoma (cT1bN3M1a, IVA) and with programmed cell death-1 positive. Brain magnetic resonance imaging (MRI) showed multiple asymptomatic bilateral cerebral infarctions as Trousseau’s syndrome. After the patient was administered pembrolizumab, bilateral cerebral infarctions were aggravated.

Management and outcome

Although the patient was given prophylactic anticoagulant therapy respectively before two doses of pembrolizumab, Trousseau’s syndrome still aggravated recurrently.

Discussion

Trousseau’s syndrome is rarely reported following the administration of ICIs. It is possible that pembrolizumab may trigger disorders of the coagulation–fibrinolysis system in cancer patients.