Background: Cancer has been widely known to grant a procoagulant state to its bearer, due to a combination of multiple local and systemic factors. Gastric adenocarcinoma is a relatively common malignancy, being one of the most prothrombotic, although rarely manifesting with portal vein thrombosis (PVT). When it occurs, it has been mainly associated with advanced disease, tumoral thrombus or an histologic hepatoid component.
Summary: We present a clinical case of a 63 year old man with PVT as presenting feature of a localized gastric adenocarcinoma (LGA) and review the existing literature on the association of both pathologies. This challenging case, besides being relevant for its rarity, brings forward the discussion about the metastatic routes, implying the importance of the hematogenous route in the absence of lymph node or hepatic metastization.
Key-messages: Upon literature review this clinical case presents itself as the first reported case of LGA presenting with PVT.
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