Trousseau sign of malignancy
Trousseau sign of malignancy | |
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Differential diagnosis | thrombophlebitis migrans |
The Trousseau sign of malignancy or Trousseau's syndrome is a
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.[6] Trousseau presciently attributed thromboembolism in malignancy to changes in blood composition rather than local inflammatory or mechanical forces. By correlating clinical observation with surgical and autopsy findings, Trousseau recognized that a localized cancer could induce a generalized hypercoagulable state in which thrombosis could occur elsewhere in the body, such as in extremities with visceral malignancy. Trousseau described several cases in which recurrent thrombosis was the presenting feature of visceral cancer, and his confidence in the utility of this connection led him to say, "So great, in my opinion, is the semiotic value of phlegmasia in the cancerous cachexia, that I regard this phlegmasia as a sign of the cancerous diathesis as certain as sanguinolent effusion into the serous cavities."
Pathophysiology
Some malignancies, especially
In patients with malignancy-associated hypercoagulable states, the blood may spontaneously form clots in the portal vessels (portal vein thrombosis), the deep veins of the limbs (deep vein thrombosis), or the superficial veins (superficial vein thrombosis) anywhere on the body. These clots present as visibly swollen blood vessels (thrombophlebitis), especially the veins, or as intermittent pain in the affected areas.
References
- ^ Trousseau's sign of visceral malignancy in GPnotebook, retrieved November 2012
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- ^ "Trousseau sign" at Dorland's Medical Dictionary
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: CS1 maint: multiple names: authors list (link - PMID 12975470.
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