A 70-year-old female patient presented to emergency room with “dyspnea and cough”. She was hypertensive from 25 years, gastric resection 10 years ago for stomach. cancer, colon cancer treated with surgery and chemotherapy in the last year.
On chest auscultation signs of pulmonary congestion. His electrocardiogram showed mild left ventricular hypertrophy and aspecific alterations. His chest x-ray revealed a area of alveolar-interstitial pneumonia.
The patient was treated with LMWH for all time of observation. After 5 days of observation the patient was discharged with a diagnosis of pneumocystis carinii pneumonia treated Cotrimoxazolo.
At home after 6 days the patient again suffered of dyspnea and tachycardia. A cardiologist specialist advised a CT pulmunary angiography. She was diagnosed to have pulmonary embolism. A subsequent ultrasound examination showed extensive deep vein thrombosis of the right leg (right common femoral vein).
She was treated with edoxaban 60 mg and elastocompressive therapy. After 20 days the patient was asymptomatic. Thrombosis of the lower limb resolved after 6 months.
This case deals with a case of pulmonary embolism. It is often forgotten that patients with cancer have a high incidence of diseases related to thromboembolism. In a patient with cancer with dyspnoea, a pulmonary embolism should always be suspected, because it is one of the common causes of death in these patients.

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