Recurrent Stroke Due to Pulmonary Vein Thrombosis in a Patient with Metastatic Lung Adenocarcinoma

BACKGROUND Pulmonary vein thrombosis (PVT) is a rare clinical entity. Etiologies include malignancy, hyper-viscosity syndromes, and other etiologies. Patients may present with dyspnea, cough, or hemoptysis. CASE REPORT We present a case of a 64-year-old man with a history of metastatic lung cancer diagnosed with PVT through transesophageal echocardiography (TEE) and complicated by 2 cerebrovascular accidents. The patient had a complicated hospital course and died later due to his malignancy burden and overall condition, despite anticoagulation therapy. CONCLUSIONS Patients with PVT are often asymptomatic or may have a nonspecific clinical presentation. Anticoagulation should be considered in patients with PVT given the life-threatening complications such as peripheral embolization. More research is needed to address this potentially catastrophic finding.