Trousseau's sign of malignancy

A medical sign indicating potential malignancy

Trousseau's sign of malignancy
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Synonyms
Pronounce	N/A
Specialty	N/A
Symptoms	Venous thrombosis, migratory thrombophlebitis
Complications	Pulmonary embolism, deep vein thrombosis
Onset
Duration
Types	N/A
Causes	Cancer, particularly pancreatic cancer
Risks
Diagnosis	Clinical evaluation, imaging, laboratory tests
Differential diagnosis	N/A
Prevention	N/A
Treatment	Anticoagulation, treatment of underlying cancer
Medication	N/A
Prognosis	Varies depending on underlying malignancy
Frequency
Deaths	N/A

Trousseau's sign of malignancy is a medical sign that indicates the presence of an underlying cancer, particularly adenocarcinomas such as pancreatic cancer. It is characterized by recurrent and migratory episodes of venous thrombosis and thrombophlebitis. This sign is named after the French physician Armand Trousseau, who first described the association between thrombophlebitis and cancer in the 19th century.

Pathophysiology

Trousseau's sign of malignancy is thought to be caused by the production of procoagulant substances by the tumor cells, which leads to a hypercoagulable state. This hypercoagulability results in the formation of blood clots in veins, which can migrate and cause thrombophlebitis. The most common cancers associated with Trousseau's sign are pancreatic cancer, lung cancer, and gastric cancer.

Clinical Presentation

Patients with Trousseau's sign of malignancy may present with symptoms of venous thrombosis, such as swelling, redness, and pain in the affected limb. The thrombosis is often migratory, meaning it can appear in different locations over time. This migratory nature is a key feature that distinguishes it from other forms of thrombophlebitis.

Diagnosis

The diagnosis of Trousseau's sign of malignancy is primarily clinical, based on the presence of migratory thrombophlebitis in a patient with a known or suspected malignancy. Additional diagnostic workup may include imaging studies such as ultrasound or CT scan to identify thrombosis and laboratory tests to assess coagulation status. Identifying the underlying malignancy is crucial and may require further imaging and biopsy.

Treatment

The treatment of Trousseau's sign of malignancy involves managing the thrombosis and addressing the underlying cancer. Anticoagulation therapy, such as heparin or warfarin, is used to prevent further clot formation. Treatment of the underlying cancer may involve surgery, chemotherapy, or radiation therapy, depending on the type and stage of the cancer.

Prognosis

The prognosis of patients with Trousseau's sign of malignancy depends on the type and stage of the underlying cancer. The presence of this sign often indicates an advanced stage of cancer, which can affect the overall prognosis.

History

Armand Trousseau first described the association between migratory thrombophlebitis and cancer in 1865. He noted that patients with certain types of cancer, particularly those of the pancreas, often developed unexplained blood clots. Trousseau himself was diagnosed with gastric cancer and experienced migratory thrombophlebitis, which he had described in his patients.

Also see

• Trousseau sign of latent tetany
• Pancreatic cancer
• Hypercoagulability
• Thrombophlebitis