Thrombotic microangiopathy as a presentation of undifferentiated metastatic carcinoma, a case report

Main Article Content

Filipa Margarida Ferreira Pereira
Ana Elisa Costa
Margarida Freitas Silva

Keywords

thrombotic microangiopathy, thrombotic thrombocytopenic purpura, cancer

Abstract

Thrombotic microangiopathy (TMA) is a group of hereditary or acquired syndromes that shared clinical and pathological characteristics: microvascular thrombosis, thrombocytopenia and ischaemic end-organ damage. Thrombotic microangiopathy can be a manifestation of a subjacent disease as cancer, infection, auto-immune disease and others. Patients presenting cancer-related TMA have an extremely poor prognosis. We report a case of a 61-year-old man who was admitted for persistent lumbar pain. Results from imagiological exams showed multiple retroperitoneal lymph nodes suggestive of metastatic cancer. A sudden clinical episode with changes in mental and behavioral status and laboratory alterations consistent with TMA, were observed. A first strategy including plasma exchange and steroids was performed with no clinical response. The retroperitoneal lymph node biopsy revealed undifferentiated carcinoma of unknown primary and then, chemotherapy was started.

Abstract 17 | PDF Downloads 10