Four Cases of Trousseau's Syndrome Associated with Lung Adenocarcinoma

Tachihara, Motoko; Nikaido, Takefumi; Wang, Xintao; Sato, Yasuko; Ishii, Taeko; Saito, Kazue; Sekine, Satoko; Tanino, Yoshinori; Ishida, Takashi; Munakata, Mitsuru

doi:10.2169/internalmedicine.51.6453

Cited by 14 publications

(14 citation statements)

References 20 publications

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“…Carcinoma-associated mucins are thought to induce platelet-rich microthrombi with increasing tissue factor and selectins, resulting in intravascular hypercoagulation (1,12). Indeed, Trousseau's syndrome is occasionally associated with mucin-producing adenocarcinoma (1,9,13). Although the present case lacks the typical findings of mucin-producing carcinoma, such as intracytoplasmic mucin or extracellular mucin pools, the serum tumor markers CA19-9 and CA125 were found to be markedly elevated.…”

Section: A B C Dmentioning

confidence: 52%

Trousseau's syndrome caused by bladder cancer producing granulocyte colony-stimulating factor and parathyroid hormone-related protein: A case report

et al. 2016

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Abstract. The present study reports a rare case of bladder cancer that caused Trousseau's syndrome, a malignancy-associated hypercoagulative state leading to venous or arterial thrombosis. A 38-year-old Japanese female patient experienced a sudden onset of visual field defects and lower limb weakness. Cerebral magnetic resonance imaging revealed multi-regional hypointense areas compatible with acute cerebral infarction. Despite the repeated administration of anticoagulant treatment with heparin, the condition could not be adequately controlled and thromboembolic events occasionally recurred. Several tumor markers, including carbohydrate antigen 19-9, cancer antigen 125, carcinoembryonic antigen, cytokeratin 19 fragment and squamous cell carcinoma antigen levels, were elevated. Consequently, computed tomography scans were performed, which revealed a massive bladder tumor with multiple bone and lymph node metastases. The patient also exhibited other paraneoplastic disorders, including leukocytosis due to granulocyte colony-stimulating factor (G-CSF) production, and hypercalcemia due to parathyroid hormone-related protein (PTHrP) production. Transurethral resection of the bladder tumor was performed, and the tumor was pathologically confirmed as urothelial cell carcinoma. Immunohistochemical testing revealed positive staining for G-CSF and PTHrP. Despite undergoing gemcitabine/cisplatin-based systemic chemotherapy, the disease developed rapidly and the patient succumbed to the disease within 3 months of initial symptoms. The present case indicates that occult visceral malignancy should be considered in patients with unexplained thromboembolism.

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Section: A B C Dmentioning

confidence: 52%

Trousseau's syndrome caused by bladder cancer producing granulocyte colony-stimulating factor and parathyroid hormone-related protein: A case report

et al. 2016

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“…Cestari et al also reported that lung cancer is the most common primary tumor associated with brain stroke, particularly embolic events, and the MST from the diagnosis of stroke is 4.5 months in cancer patients (11). Several case reports of Trousseau's syndrome associated with lung cancer have already been published, and most cases demonstrated poor prognoses for several months (9,(12)(13)(14).…”

Section: Discussionmentioning

confidence: 99%

“…In terms of histopathology, patients with lung adenocarcinoma, particularly mucin-producing adenocarcinoma, are at an increased risk for venous thrombosis compared with patients with squamous cell carcinoma (2,8). Tachihara and colleagues presumed that elevation of markers, such as KL-6, might be a predictive factor for coagulopathy and reflect histopathological subtype (9). Furthermore, the risk of venous thrombosis in patients with distant metastasis is six-fold higher than that in patients that only have local tumor growth (8).…”

Section: Discussionmentioning

confidence: 99%

Lung Adenocarcinoma Complicated by Trousseau's Syndrome Successfully Treated by a Combination of Anticoagulant Therapy and Chemotherapy

et al. 2014

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A 63-year-old woman was diagnosed with advanced lung adenocarcinoma complicated by Trousseau's syndrome characterized by non-bacterial thrombotic endocarditis, asymptomatic brain infarction, deep venous thrombosis, and low-grade disseminated intravascular coagulation (DIC). The patient's DIC rapidly became widespread, and multiple micropulmonary embolisms led to severe respiratory failure. She received a blood transfusion and anticoagulant treatment with heparin and recombinant human soluble thrombomodulin, which modestly ameliorated her symptoms, and additional chemotherapy led to tumor shrinkage with concomitant resolution of Trousseau's syndrome. Although there are no established medical approaches for managing Trousseau's syndrome, intensive anticoagulant treatment may be effective for improving the patients' general condition in order for them to be able to undergo subsequent combination chemotherapy.

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“…The internal jugular vein (IJV) is a rare site for spontaneous thrombosis, and IJV thrombosis is usually a result of intravenous drug abuse, prolonged central venous catheterization, invasive head and neck infections or head and neck trauma. However, the findings concerning the relationship between IJV thrombosis and distant malignancies have been reported previously (1,2). Armand Trousseau was the first to describe this relationship between venous thromboembolic features and malignancies, such as lung cancer, and therefore this condition is known as Trousseau's syndrome (1).…”

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confidence: 99%

Spontaneous Internal Jugular Vein Thrombosis Associated with Lung Cancer

et al. 2013

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A 70-year-old woman was admitted to the emergency room at our hospital with painful swelling on the left posterior triangle of her neck that had progressively worsened over three days. A physical examination revealed normal findings with the exception of diffuse fullness in the left posterior neck. A contrasted computed tomography (CT) scan of the neck and thorax revealed a left jugular venous thrombus and the presence of a mass in the left upper lobe that measured approximately 5×3.5 cm (Picture). No additional thrombi were discovered in the systemic venous system. A transbronchial biopsy of the mass revealed the presence of non-small cell lung cancer.

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Four Cases of Trousseau's Syndrome Associated with Lung Adenocarcinoma

Cited by 14 publications

References 20 publications

Trousseau's syndrome caused by bladder cancer producing granulocyte colony-stimulating factor and parathyroid hormone-related protein: A case report

Trousseau's syndrome caused by bladder cancer producing granulocyte colony-stimulating factor and parathyroid hormone-related protein: A case report

Lung Adenocarcinoma Complicated by Trousseau's Syndrome Successfully Treated by a Combination of Anticoagulant Therapy and Chemotherapy

Spontaneous Internal Jugular Vein Thrombosis Associated with Lung Cancer

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