• Lisha Wang, Yan Xu, Minghui Tuo, Lei Zhang, Hong Zhang, and Jing Wang.
• Department of Neurology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province, People's Republic of China.
• Medicine (Baltimore). 2018 Feb 1; 97 (5): e9815.

RationaleRepeated occurring stroke in short intervals with hypercoagulability is unusual so in such cases the conventional vascular risk factors might not be the causes of stroke.Patient ConcernsWe have presented a case of 60-year-old male presenting with recurrent stroke due to thrombophilia.DiagnosesLung cancer was detected by superficial lymph nodes ultrasound and further pathological examination.InterventionsThe patient suffered a recurrent stroke and he had persistently high level of D-dimer which suggested the diagnosis of thrombophilia, thus, he was treated with low-molecular-weight heparin. Unfortunately, the treatment was not effective for the patient and he died before any other treatments could be administered.OutcomesDespite anticoagulant therapy, the patient suffered multiple episodes of stroke and ultimately died.LessonsThis case of recurrent stroke with coagulation disorders without evidence of cancer in imaging and blood test is rare. So in a stroke patient, we should consider malignancy or metastasis as a differential diagnosis as it may be the first manifestation of active cancer elsewhere.

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