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Acute ventricular and aortic thrombosis post chemotherapy

Royal Free Hospital, Pond Street, London, UK

Correspondence: Dr James Bell, Royal Free Hospital, 10 Pond Street, London NW3 2QG, UK. E-mail: james.bell{at}royalfree.nhs.uk

We present a rare case of spontaneous arterial thrombosis in a 42-year-old male with an acute history of bilateral lower limb pain and weakness. The previous day he had received the first cycle of cisplatin-based chemotherapy for oesophageal adenocarcinoma (T2/3N0/M0). Computed tomography (CT) and angiography showed extensive abdominal aortic thrombus in a native non-aneurysmal or grossly atheromatous aorta with separate thrombus in the left ventricle. We suggest that poor left ventricular function, a hypercoaguable state secondary to malignancy and cisplatin based chemotherapy may have induced severe arterial and intra-cardiac thrombosis.