Trousseau sign of malignancy

Trousseau sign of malignancy is a medical sign that indicates the presence of certain types of cancer. It is named after the French physician Armand Trousseau, who first described the phenomenon in the 19th century. This sign is characterized by the occurrence of venous thrombosis and hypercoagulability in patients with an underlying malignancy.

Pathophysiology

The Trousseau sign of malignancy is associated with a hypercoagulable state, which is a common paraneoplastic syndrome. This condition is often seen in patients with adenocarcinomas, particularly those of the pancreas, lung, and stomach. The underlying mechanism involves the release of procoagulant substances by the tumor cells, which leads to an increased tendency for blood clot formation.

Clinical Presentation

Patients with Trousseau sign of malignancy may present with recurrent and migratory thrombophlebitis, which is inflammation of the veins due to blood clots. These clots can occur in superficial or deep veins and may lead to complications such as deep vein thrombosis (DVT) or pulmonary embolism (PE).

Diagnosis

The diagnosis of Trousseau sign of malignancy is primarily clinical, based on the presence of unexplained and recurrent venous thrombosis in a patient. Further diagnostic workup may include imaging studies and laboratory tests to identify the underlying malignancy. Common investigations include computed tomography (CT) scans, magnetic resonance imaging (MRI), and blood tests for tumor markers.

Management

The management of Trousseau sign of malignancy involves treating both the thrombotic events and the underlying cancer. Anticoagulation therapy is typically used to prevent further clot formation. This may include medications such as heparin, warfarin, or direct oral anticoagulants (DOACs). Treatment of the underlying malignancy may involve surgery, chemotherapy, or radiation therapy.

Prognosis

The prognosis of patients with Trousseau sign of malignancy depends on the type and stage of the underlying cancer. The presence of this sign often indicates an advanced stage of malignancy and may be associated with a poorer prognosis.

History

The Trousseau sign of malignancy was first described by Armand Trousseau in 1865. Trousseau himself was diagnosed with gastric cancer and experienced migratory thrombophlebitis, which led him to identify and describe this clinical sign.

See also

• Paraneoplastic syndrome
• Thrombophlebitis
• Hypercoagulability
• Venous thrombosis