Abstract
Cancer-associated thrombosis is known as Trousseau syndrome (TS). Here, we report 4 cases of TS associated with advanced breast cancer that caused central nervous system (CNS) vascular events. All 4 patients experienced sudden onset of CNS symptoms. Imaging revealed multiple brain infarctions or intracranial hemorrhage and all 4 patients had leptomeningeal or brain metastasis. Laboratory findings showed hypercoagulability at diagnosis of TS. Of the 4 patients, 2 patients were treated with unfractionated heparin, while 2 patients could not undergo anticoagulant therapy. In all patients, once the TS occurred, the CNS symptoms progressed rapidly and the prognosis was very poor, 3 patients dying within about a month of diagnosis of TS. Therefore, the predictive factors of TS are important and standards and guidelines for administration of anticoagulants are needed.
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References
Trousseau A. (1865) Phlegmasia alba dolens. Clinique Medicale de 1’Hotel-Dieu De Paris, vol 3, pp 654–712
Varki A (2007) Trousseau’s syndrome: multiple definitions and multiple mechanisms. Blood 15(110):1723–1729
Brose KM, Lee AY (2008) Cancer-associated thrombosis: prevention and treatment. Curr Oncol 15:58–67
Pineo GF, Brain MC, Gallus AS et al (1974) Tumors, mucus production, and hypercoagulability. Ann NY Acad Sci 230:262–270
Khorana AA, Francis CW, Culakova E et al (2007) Thromboembolism is a leading cause of death in cancer receiving outpatient chemotherapy. J Thromb Haemost 5:632–634
Tachihara M, Nikaido T, Wang X et al (2012) Four cases of Trousseau's syndrome associated with lung adenocarcinoma. Intern Med 51:1099–1102
Ikushima S, Ono R, Fukuda K et al (2016) Trousseau’s syndrome: cancer-associated thrombosis. Jpn J Clin Oncol 46:204–208
Wahrenbrock M, Borsig L, Le D et al (2003) Selectin–mucin interactions as a probable molecular explanation for the association of Trousseau syndrome with mucinous adenocarcinomas. J Clin Invest 112:853–862
Kakkar AK, Levine MN, Kadziola Z et al (2004) Low molecular weight heparin, therapy with dalteparin, and survival in advanced cancer: the fragmin advanced malignancy outcome study (FAMOUS). J Clin Oncol 22:1944–1948
Ishikawa M, Nakayama K, Ishibashi T et al (2016) Case series of cerebral infarction with Trousseau’s syndrome associated with malignant gynecological tumors. Mol Clin Oncol 5:138–142
Lyman GH, Bohlke K, Falanga A (2015) Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Oncol Pract 11:e442–e444
Farge D, Debourdeau P, Beckers M et al (2013) International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer. Thromb Haemost 11:56–70
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We thank Tomas D Mayers, Medical English Communications Center, University of Tsukuba, for excellent English proofreading.
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Okazaki, M., Bando, H., Ichioka, E. et al. Four cases of Trousseau syndrome associated with breast cancer that exhibited central nervous system manifestations. Int Canc Conf J 9, 146–150 (2020). https://doi.org/10.1007/s13691-020-00411-9
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DOI: https://doi.org/10.1007/s13691-020-00411-9