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Abstract Details

Case report: Diagnosis of Occult Cancer in Acute Ischemic Stroke Using Positron Emission Tomography Combined with Computed Tomography
Cerebrovascular Disease and Interventional Neurology
P11 - Poster Session 11 (8:00 AM-9:00 AM)
4-007
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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.
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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.
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.
Authors/Disclosures
Bastien Rioux, MD (Université de Montréal)
PRESENTER 		Dr. Rioux has nothing to disclose.
Mark R. Keezer, MD, PhD (Centre Hospitalier Universite de Montreal) The institution of Dr. Keezer has received research support from TD Bank. The institution of Dr. Keezer has received research support from Savoy Foundation. The institution of Dr. Keezer has received research support from Canadian Institutes of Health Research. The institution of Dr. Keezer has received research support from Fonds de Recherche Québec Santé. The institution of Dr. Keezer has received research support from Canadian Institutes of Health Research. The institution of Dr. Keezer has received research support from Precision Child Health Partnership Catalyst Program.
Laura C. Gioia, MD (Notre-Dame Hospital) Dr. Gioia has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Servier Inc.