Trousseau sign of malignancy

The Trousseau sign of malignancy is a medical sign found in certain cancers that is associated with venous thrombosis^[1] and hypercoagulability. It is also referred to as Trousseau syndrome^[2] and is distinct from the Trousseau sign of latent tetany.

History

Armand Trousseau first described this finding in the 1860s; he later found the same sign in himself, was subsequently diagnosed with gastric cancer and died soon thereafter.^[3]

Pathophysiology

Some malignancies, especially adenocarcinomas of the pancreas and lung, are associated with hypercoagulability (the tendency to form blood clots) for reasons that are incompletely understood, but may be related to factors secreted by the tumors, in particular a circulating pool of cell-derived tissue factor-containing microvesicles.^[4]

In patients with malignancy-associated hypercoagulable states, the blood may spontaneously form clots in the portal vessels, the deep veins of the extremities (such as the leg), or the superficial veins anywhere on the body. These clots present as visibly swollen blood vessels (vasculitis), especially the veins, or as intermittent pain in the affected areas. The pathological phenomenon of clots forming, resolving and then appearing again elsewhere in the body has been named thrombophlebitis migrans or migratory thrombophlebitis.

References

1. ^ "Trousseau sign" at Dorland's Medical Dictionary
2. ^ "Trousseau syndrome" at Dorland's Medical Dictionary
3. ^ Samuels MA, King ME, Balis U (October 2002). "Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 31-2002. A 61-year-old man with headache and multiple infarcts". N. Engl. J. Med. 347 (15): 1187–94. doi:10.1056/NEJMcpc020117. PMID 12374880. 
4. ^ Del Conde I, Bharwani LD, Dietzen DJ, Pendurthi U, Thiagarajan P, López JA.(2007) Microvesicle-associated tissue factor and Trousseau's syndrome. J Thromb Haemost 5:70-4