Two Patients with Arterial Thromboembolism among 311 Patients with Adenocarcinoma of the Pancreas

To examine the prevalence and characteristics of arterial thromboembolism in patients with adenocarcinoma of the pancreas. Retrospective review of charts of all patients with cancer of the pancreas diagnosed and followed at a regional teaching hospital over a decade. In total, 320 patients were diagnosed and 311 were available for evaluation. Two patients with arterial thromboembolism were identified (0.65%) and studied. Both had extensive metastatic disease on diagnosis and, soon after, developed an acute arterial occlusion of the iliac and femoral arteries, with no identifiable embolic source (case 1) or acute intestinal infarction due to mesenteric and multiple other embolic arterial occlusions associated with nonbacterial thrombotic endocarditis (NBTE) of the mitral valve (case 2). Both cases had laboratory evidence of disseminated intravascular coagulation and succumbed to their illnesses within a very short time. Arterial occlusion in pancreatic cancer is a rare preterminal event that may be caused by cardiogenic emboli from NBTE or to thrombosis in situ. The pathogenesis is briefly reviewed.