Thrombotic event in patient with cancer is a common feature in contrary to the presentation of thombotic disordersthat part of para neoplastic syndrome as a solely initial symptom of an occult malignancy. The underlying mechanism thatassociating between cancer and thrombosis as well as between cancer and paraneoplastic syndrome is not clearly understoodyet. One of those cancers that frequently associated with paraneoplastic syndrome is lung cancer. We reported a 46 years oldwoman that presents initially because of a swollen left leg and tenderness along the leg. Other examinations within normalfinding including normal chest x ray. In approximately a year later, the patient experiences disturbing cough with blood streak,accompany with shortness of breath. She was also complaining of sharp chest pain especially when taking a deep breath.After several examinations performed such as bronchoscopy with bronchial washing, transthoracal biopsy, sonographic study,echocardiography, chest CT scan, this patient was finally diagnose of having advanced lung malignancy. Histologic finding wascomfirm with adeno carcinoma poorly differentiated. He was treated under 6 concecutive cycles of gemzitabin combined withcarboplatin. Despite completed chemotherapy treatment, she became worst and died because of respiratory failure
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