Case Report: Perioperative management of ovarian cancer surgery in suspected trousseau's syndrome with recent ischemic stroke and acute myocardial injury

Purpose To describe the perioperative management for ovarian cancer surgery in a patient with suspected Trousseau's syndrome complicated by recent ischemic stroke and acute myocardial injury. Case presentation A 43-year-old woman with ovarian cancer developed recurrent cerebral infarctions and acute myocardial injury with dynamic ECG changes during anticoagulation. After multidisciplinary assessment of the competing risks of further surgical delay and intervention, definitive tumor surgery was undertaken under general anesthesia. Postoperatively, delayed emergence and marked troponin elevation occurred without clinically evident new neurological deficit or cardiac, symptomatic cardiac dysfunction, or ongoing cardiovascular instability. Conclusion This case illustrates individualized perioperative management in a patient with malignancy-associated hypercoagulability, emphasizing multidisciplinary decision-making, diagnostic restraint, and tailored perioperative care.