title: [Paraneoplastic thrombosis of the internal jugular and subclavian veins as first manifestation of gall bladder cancer].
abstract: METHODS
  A 69-year-old woman presented with a cervical swelling of unknown cause.
  
  
  METHODS
  Computed tomograph (CT) and phlebography showed extensive thrombosis of sigmoid sinus and the internal jugular, brachiocephalic and subclavian veins on the left side. Blood coagulation tests were unremarkable. A paraneoplastic cause for the thrombosis could be ruled out as well. The CT revealed only cholecystolithiasis and anadrenal incidentaloma.
  
  
  METHODS
  Oral anticoagulation was initiated. One year later a carcinoma of the gall bladder with involvement of the liver was detected at laparoscopic cholecystectomy. Reoperation was performed but not all tumor tissue was resected. Nine months later an intraabdominal metastasis was excised.
  
  
  CONCLUSIONS
  If a paraneoplastic thrombosis but susected but the search for a tumor has been unsuccessful, even an asymptomatic cholecystolithiasis should be treated with a cholecystectomy.
authors.affiliation: Chirurgische Klinik I, Lukaskrankenhaus Neuss. denis.wirowski@t-online.de
authors.forename: D
authors.initials: D
authors.lastname: Wirowski
authors.forename: J
authors.initials: J
authors.lastname: Treckmann
authors.forename: H
authors.initials: H
authors.lastname: Böhner
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging; D000368:Aged; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005706:Gallbladder Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007601:Jugular Veins; D010257:Paraneoplastic Syndromes / Q000000981:diagnostic imaging* / Q000209:etiology; D010690:Phlebography; D012086:Reoperation; D013350:Subclavian Vein; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed