Infartos cerebrales isquémicos de repeticiÓn por hipercoagulabilidad adquirida en el adenocarcinoma de prÓstata

Hypercoagulable states are frequently associated to malignancies. We report the case of a 67 year-old patient with prostatic cancer (T3NxM1) and deep venous thrombosis, whose initial coagulation studies were normal. He was treated with acenocumarol and hormonal blockade with flutamide and leuprolerin acetate. Six months later he developed recurrent brain ischemic strokes in the territories of both median cerebral arteries, that did not respond to anticoagulant treatment. Coagulation studies, showed a procoagulant activity with a probable paraneoplastic origin. We conclude that prostatic adenocarcinoma treated with hormonal blockage may promote a complex procoagulant state leading to recurrent occlusive arterial disease, refractory to anticoagulation.