Long‑term control in a patient with lung adenocarcinoma, nonbacterial thrombotic endocarditis and multiple systemic emboli: A case report

• Published in: Experimental and therapeutic medicine Vol. 27; no. 2; p. 81
• Main Authors: Kawakami, Takeshi, Sasatani, Yuika, Hasegawa, Sachie, Ohara, Gen, Okauchi, Shinichiro, Taguchi, Manato, Ojima, Eiji, Satoh, Hiroaki, Hizawa, Nobuyuki
• Format: Journal Article
• Language: English
• Published: Greece Spandidos Publications 01.02.2024; Spandidos Publications UK Ltd; D.A. Spandidos
• Subjects: Adenocarcinoma; Anticoagulants; Anticoagulants (Medicine); Brain cancer; Brain tumors; Cancer; Cancer therapies; Cardiac arrhythmia; Care and treatment; Case Report; Case reports; Development and progression; Diagnosis; Disease; Drug therapy; Endocarditis; Lung cancer; Lung cancer, Non-small cell; Medical imaging; Medical prognosis; Metastasis; Molecular weight; Oncology, Experimental; Patients; Pemetrexed; Pulmonary embolisms; Thromboembolism; Thrombosis; Vegetation; Veins & arteries; Japan; pembrolizmab; immune checkpoint inhibitor; nonbacterial thrombotic endocarditis; systemic emboli; lung adenocarcinoma
• ISSN: 1792-0981; 1792-1015
• DOI: 10.3892/etm.2024.12370

Systemic emboli are not uncommon in patients with advanced non-small cell lung cancer. The present study describes a rare case of long-term control in a patient with lung adenocarcinoma, nonbacterial thrombotic endocarditis and multiple systemic emboli. Briefly, a 56-year-old man was diagnosed with metastatic lung adenocarcinoma and was treated with pembrolizumab, which was discontinued due to the appearance of a pulmonary immune-related adverse event. During the clinical course, the patient developed pseudo-progression of a brain tumor, repeated thromboembolism in multiple organs and a small vegetation attached to the aortic valve. These lesions were controlled with apixaban after heparin therapy for >3 years. Lung cancer was subsequently treated with pemetrexed and bevacizumab; however, this treatment was terminated due to a complete response and the patient's request to discontinue treatment. More than 3 years have passed since the diagnosis of lung adenocarcinoma, and the patient has been followed up at the hospital without signs of cancer recurrence. Although unusual, the patient's course may provide useful suggestions for the treatment of other patients with a similar evolution.