title: Trousseau's syndrome in a patient with advanced stage gastric cancer.
abstract: Patients with cancer are at high risk for thrombotic events, which are known collectively as Trousseau's syndrome. Herein, we report a 66-year-old male patient who was diagnosed with terminal stage gastric cancer and liver metastasis and who had an initial clinical presentation of upper gastrointestinal bleeding. Acute ischemia of the left lower leg that resulted in gangrenous changes occurred during admission. Subsequent angiography of the left lower limb was then performed. This procedure revealed arterial thrombosis of the left common iliac artery with extension to the external iliac artery, the left common iliac artery, the posterior tibial artery, and the peroneal artery, which were occluded by thrombi. Aspiration of the thrombi demonstrated that these were not tumor thrombi. The interesting aspect of our case was that the disease it presented as arterial thrombotic events, which may correlate with gastric adenocarcinoma. In summary, we suggested that the unexplained thrombotic events might be one of the initial presentations of occult malignancy and that thromboprophylaxis should always be considered.
authors.affiliation: Tai-Long Chien, Division of Gastroenterology, Department of Internal Medicine, Pin-Tung An-Tai Hospital, Pintung County 92842, Taiwan.
authors.forename: Tai-Long
authors.initials: TL
authors.lastname: Chien
authors.affiliation: Tai-Long Chien, Division of Gastroenterology, Department of Internal Medicine, Pin-Tung An-Tai Hospital, Pintung County 92842, Taiwan.
authors.forename: Kung-Ming
authors.initials: KM
authors.lastname: Rau
authors.affiliation: Tai-Long Chien, Division of Gastroenterology, Department of Internal Medicine, Pin-Tung An-Tai Hospital, Pintung County 92842, Taiwan.
authors.forename: Wen-Jung
authors.initials: WJ
authors.lastname: Chung
authors.affiliation: Tai-Long Chien, Division of Gastroenterology, Department of Internal Medicine, Pin-Tung An-Tai Hospital, Pintung County 92842, Taiwan.
authors.forename: Wei-Chen
authors.initials: WC
authors.lastname: Tai
authors.affiliation: Tai-Long Chien, Division of Gastroenterology, Department of Internal Medicine, Pin-Tung An-Tai Hospital, Pintung County 92842, Taiwan.
authors.forename: Shih-Ho
authors.initials: SH
authors.lastname: Wang
authors.affiliation: Tai-Long Chien, Division of Gastroenterology, Department of Internal Medicine, Pin-Tung An-Tai Hospital, Pintung County 92842, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Chiu
authors.affiliation: Tai-Long Chien, Division of Gastroenterology, Department of Internal Medicine, Pin-Tung An-Tai Hospital, Pintung County 92842, Taiwan.
authors.forename: Keng-Liang
authors.initials: KL
authors.lastname: Wu
authors.affiliation: Tai-Long Chien, Division of Gastroenterology, Department of Internal Medicine, Pin-Tung An-Tai Hospital, Pintung County 92842, Taiwan.
authors.forename: Yeh-Pin
authors.initials: YP
authors.lastname: Chou
authors.affiliation: Tai-Long Chien, Division of Gastroenterology, Department of Internal Medicine, Pin-Tung An-Tai Hospital, Pintung County 92842, Taiwan.
authors.forename: Chia-Che
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Tai-Long Chien, Division of Gastroenterology, Department of Internal Medicine, Pin-Tung An-Tai Hospital, Pintung County 92842, Taiwan.
authors.forename: Yen-Hao
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Tai-Long Chien, Division of Gastroenterology, Department of Internal Medicine, Pin-Tung An-Tai Hospital, Pintung County 92842, Taiwan.
authors.forename: Seng-Kee
authors.initials: SK
authors.lastname: Chuah
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000556:secondary; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001706:Biopsy; D057510:Endovascular Procedures / Q000295:instrumentation; D005773:Gastroscopy; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008113:Liver Neoplasms / Q000556:secondary; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D009367:Neoplasm Staging; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications* / Q000473:pathology; D013577:Syndrome; D017131:Thrombectomy; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome
keywords: Arterial thrombotic events; Gastric cancer; Thromboprophylaxis; Trousseau’s syndrome; Vascular thrombosis