A RARE CASE OF MULTIPLE MULTIPLE ORGAN ISCHEMIC LESIONS IN A CANCER PATIENT

V.P. Nefedov, B.P. Davidov

The Medical and Sanitary Part of the Kazan (Volga Region) Federal University, Kazan

Nefedov Valeriy P. ― Cand. of Sci. (Med.), pathologist of the pathology department of the Medical and Sanitary Part of the Kazan (Volga Region) Federal University

1a Chekhov Str., Kazan, 420099, Russian Federation, e-mail: nefedovvp1941@mail.ru, ORCID ID: 0000-0001-7936-6889

Abstract. In medical practice, cases of fatal outcomes of patients are often found when two deadly diseases are diagnosed at an autopsy. Then the pathologist has to solve the issue of the competitiveness of two pathological processes and the leading role of one of them in thanatogenesis [1]. It is necessary to think about the pathogenetic relationship of two such diseases.

The case presented by us is a typical example of the multipolarity of pathological ischemic processes, which are based on a malignant tumor.

Patient N., 53 years old, was admitted for autopsy on 12.02.24. with a clinical diagnosis: Pancreatic cancer with liver metastases, acute thrombosis of the right femoral artery, chronic occlusion of the tibial vessels and deep vein thrombosis of the left lower limb, amputation of the right lower limb on a level in 3 of the shin from 26.01.24, multiple organ failure, ischemic stroke in the right SMA basin (atherothrombotic subtype) with left-sided hemiplegia (from 18.12.2013), atrophic changes in the frontal-parietal regions of the cerebral hemispheres (according to MRI data), coagulopathy, severe anemia, hepatomegaly, retroperitoneal lymphadenopathy, left-sided hydrothorax, atelectasis of the lower lobe of the left lung, hypostasis of the lungs.

Backgound. There are few works devoted to pancreatic cancer in the modern scientific literature.

Aim ― to describe a rare case of pancreatic body cancer complicated by hypercoagulation syndrome with subsequent development of ischemic lesions brain, heart, spleen, left kidney and lower extremities.

Material and methods. The presented materials of autopsy and histological examination of the organs of a patient with pancreatic cancer.

Results. Attention is drawn to the fact that despite multiple metastases of low-grade pancreatic adenocarcinoma to the liver, lungs, heart, left adrenal gland and lymph nodes of the abdominal cavity, the patient died not directly from the tumor process, but from hemodynamic disorders associated with the formation of fibrin clots on the aortic and mitral valves of the heart, as well as in the vessels of internal organs. A massive infarction in the right hemisphere of the brain with the development of edema and dislocation of the brain led to the death of a woman at the age of 53.

Key words: pancreatic cancer, hypercoagulation syndrome, ischemic organ damage.