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An, Lee, Park, Lee, Yang, Park, and Lee: Lung Cancer Presented as Painful Swelling of Lower Legs
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 61(4): 398-402.

Published online: 31 October 2006

DOI: https://doi.org/10.4046/trd.2006.61.4.398

Lung Cancer Presented as Painful Swelling of Lower Legs

Jin Young An, M.D., Jang Eun Lee, M.D.1, Hyung wook Park, M.D.1, Jeong hwa Lee, M.D.1, Seung Ah Yang, M.D.1, Young Kun Park, M.D., Sang Rok Lee, M.D.

Department of Internal Medicine, Cheongju St. Mary's Hospital, Cheongju, Korea.

1Department of Internal Medicine, The Catholic University of Korea, Cheongju, Korea.

Adress for Correspondence: Jin Young An, M.D. Department of Internal Medicine, Cheongju St. Mary's Hospital 589-5, Jujungdong, Sangdangku, Cheongju 360-568, Korea. Phone: 043-219-8118 Fax: 043-211-9030, drahnjy@mdhouse.com

Received 12 January 2006       Accepted 8 September 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Trousseau's syndrome comsists of migratory thrombophlebitis and thromboembolic disorders of the venous and arterial systems in a malignancy or occult cancer. The overall incidence has been reported to vary from 1 to 11%. Pancreatic, lung, prostate, and stomach cancer is associated with the greatest risk of thromboembolic events. We encountered a 49-year-old man who presented with painful swelling of his lower legs. The chest radiograph showed increased opacity of the Left middle lung fields and Doppler sonography showed a thrombus in the left superficial femoral vein. Chest Computed Tomography showed a 5cm sized left hilar mass invading the pericardium with lymphadenopathy. The bronchoscope biopsy demonstrated an adenocarcinoma of the lung. Platinum based chemotherapy and anticoagulant therapy with warfarin was carried out. The patient was later discharged with an improvement in the painful swelling of his lower legs.

Keywords: lung cancer, Trousseau's syndrome

Figures and Tables

Figure 1
Chest radiograph shows increased opacity of Left middle lung fields.
trd-61-398-g001
Figure 2
Chest Computed tomography(CT) shows 5 cm sized Left hilar mass invading pericardium with lymphadenopathy.
trd-61-398-g002
Figure 3
Abdomen Computed tomography(CT) shows diffuse thrombosis from infrarenal level of Inferior vena cava (A) to both superfical femoral (B)
trd-61-398-g003

References

1. Sharp AA. Diagnosis and management of disseminated intravascular coagulation. Br Med Bull. 1977. 33:265–272.
2. Donati MB. Cancer and thrombosis. Haemostasis. 1994. 24:128–131.
3. Sack GH Jr, Levin J, Bell WR. Trousseau's syndrome and other manifestations of chronic disseminated coagulopathy in patient with neoplasms: clinical, pathologic, and therapeutic features. Medicine. 1977. 56:1–37.
4. Trousseau A. Phlegmasia alba dolens. Clinique mediciale de l'hotel-dieu de Paris. 1865. London: New Sydenham Society;282–332.
5. Naschitz JE, Yeshurun D, Abramson J, Eldar S, Chouri H, Kedar S, et al. Ischemic heart disease precipitated by occult cancer. Cancer. 1992. 69:2712–2720.
6. Bick RL. Cancer-associated thrombosis. N Engl J Med. 2003. 349:109–111.
7. Liu PG, Jacobs JB, Reede D. Trousseau's syndrome in the head and neck. Am J Otolaryngol. 1985. 6:405–408.
8. Vicente Prados EJ, Tallada BM, Pastor J, Martinez MA, Cozar Olmo JM, Espejo ME, et al. Renal adenocarcinoma with vena cava invasion: current status of its diagnosis and treatment using total segmentary cavecromy. Arch Esp Urol. 1998. 51:35–41.
9. Goldenberg N, Kahn SR, Solymoss S. Markers of coagulation and angiogenesis in cancer-associated venous thromboembolism. J Clin Oncol. 2003. 21:4194–4199.
10. Zacharski LR, Henderson WG, Rickles FR, Forman WB, Cornell CJ Jr, Forcier RJ, et al. Effect of warfarin anticoagulation on survival in carcinoma of the lung, colon, head and neck, and prostate: final report of Vaterans Administration Cooperative Study #75. Cancer. 1984. 53:2046–2052.
11. Callander N, Rappaport SI. Trousseau's syndrome. West J Med. 1993. 158:364–371.
12. Hines JF, Tucker A, Grendys EC, Ascher SM, Barter JF. Spontaneous preoperative internal jugular and subclavian vein thrombosis associated with an early stage synchronous ovarian/endometrial malignancy. Gynecol Oncol. 1995. 56:298–301.
13. Lee AY, Levine MN, Baker RI, Bowden C, Kakkar AK, Prins M, et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med. 2003. 349:146–153.
14. vander Heijden JF, Hutten BA, Buller HR, Prins MH. Vitamin K antagonist or low-molecular-weight heparin for the longterm treatment of symptomatic venous thromboembolism. Cochrance Database Syst Rev. 2000. (4):CD002001.
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