아빠

2024-09-01

췌장의 꼬리의 악성 신생물

어쩌면 편집증적인 기록

뇌경색

Pancreatic cancer, metastatic liver

Genetic profile:

KRAS G12D mutation: Common in pancreatic cancer, associated with poor prognosis
TP53 R273C mutation: Tumor suppressor gene mutation, often seen in aggressive cancers
CDKN2A R58Pfs*63: Another tumor suppressor gene mutation, frequently found in pancreatic cancer

On palliative mFOLFIRINOX chemotherapy (24.08.16-)

Severe mitral regurgitation MR; Mass like lesion at MV, nodular thickening of AV

could be due to Non-bacterial thrombotic endocarditis (NBTE) or Infective endocarditis (IE)

Multifocal acute infarction (24.08)

Nonbacterial thrombotic endocarditis (NBTE) has a significant association with pancreatic cancer.

NBTE is a rare condition that most often accompanies malignant diseases, with pancreatic cancer being one of the highest-risk malignancies[1][2]. Autopsy studies have found NBTE rates ranging from 0.9-1.6%, with some of the highest rates observed in patients with pancreatic cancer[8].

The link between pancreatic cancer and NBTE involves a hypercoagulable state:

Pancreatic cancer cells release prothrombotic molecules (혈전성 분자) like tissue factor (조직 인자) and cancer procoagulant (암 응고제)[5].
This leads to the formation of sterile vegetations consisting of fibrin (피브린) and platelets (혈소판) on heart valves[2].
If dislodged, these vegetations can cause systemic emboli (색전증), particularly to the brain.

NBTE in pancreatic cancer patients can manifest as: