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JAMA Oncology Clinical Challenge
April 23, 2020

Cardiac Masses in a Patient With Pancreatic Adenocarcinoma and a History of Breast Carcinoma

Author Affiliations
  • 1Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
  • 2Division of Cardiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
JAMA Oncol. 2020;6(6):917-918. doi:10.1001/jamaoncol.2020.0086

A 64-year-old woman with borderline resectable pancreatic adenocarcinoma and a history of hormone receptor–positive left-sided breast cancer (treated with lumpectomy and radiation in 2014) was transferred to our hospital for management of a displaced percutaneous hepatobiliary drain. She was diagnosed as having pancreatic adenocarcinoma in September 2019 after developing right upper quadrant pain and jaundice, which prompted imaging and a subsequent endoscopic biopsy of a pancreatic head mass. She established oncologic care in Kentucky and received 1 dose of gemcitabine plus nanoparticle albumin-bound (nab)–paclitaxel in early October 2019. Her posttreatment course was complicated by elevated levels of transaminases, significant fatigue, and an infusion port thrombosis. Her infusion port (right sided) was subsequently removed, and she was given 1.5 mg/kg of enoxaparin daily for anticoagulation.

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