Журнал клинических случаев

Adenomyosis-associated Recurrent Acute Cerebral Infarction Mimicking Trousseau's Syndrome: A Case Study and Review of Literature

Abstract

Nobuhiko Arai*, Kazunari Yachi, Ryutao Ishihara and Takao Fukushima

Adenomyosis is a common, benign uterine disease. Acute cerebral infarction (CI) associated with adenomyosis is rarely reported and difficult to treat. We experienced successful treatment for this disease. A 50-year-old woman presented with a two-day history of visual disturbance. Magnetic resonance imaging showed multiple tiny diffusion-weighted high-density spots on several lobes. No common risk factors for stroke were detected. Cancer antigen 125 Level was 999 U/mL, along with massively expanded uterus and adnexa. Based on the diagnosis of benign adenomyosis, direct oral anticoagulants and GnRH agonists were administered for CI and adenomyosis, respectively. Acute CI recurred seven days after admission. We suspected a relationship between infarction and adenomyosis, and concluded hysterectomy as a proper treatment strategy based on literature. Eighteen months after hysterectomy, no recurrence of CI without anti-thrombus medications has been detected. Hysterectomy is a radical therapy that is effective in preventing acute CI due to adenomyosis.