Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Lung Cancer Presented as Painful Swelling of Lower Legs

하지의 통증 및 부종을 주소로 내원한 환자에서 발견된 폐암1예

  • An, Jin Young (Department of Internal Medicine, Cheongju St. Mary's Hospital) ;
  • Lee, Jang Eun (Department of Internal Medicine, The Catholic University of Korea) ;
  • Park, Hyung Wook (Department of Internal Medicine, The Catholic University of Korea) ;
  • Lee, Jeong hwa (Department of Internal Medicine, The Catholic University of Korea) ;
  • Yang, Seung Ah (Department of Internal Medicine, The Catholic University of Korea) ;
  • Park, Young Kun (Department of Internal Medicine, Cheongju St. Mary's Hospital) ;
  • Lee, Sang Rok (Department of Internal Medicine, Cheongju St. Mary's Hospital)
  • 안진영 (청주 성모병원 내과학교실) ;
  • 이장은 (가톨릭 의과대학 내과학교실) ;
  • 박형욱 (가톨릭 의과대학 내과학교실) ;
  • 이정화 (가톨릭 의과대학 내과학교실) ;
  • 양승아 (가톨릭 의과대학 내과학교실) ;
  • 박용근 (청주 성모병원 내과학교실) ;
  • 이상록 (청주 성모병원 내과학교실)
  • Received : 2006.01.12
  • Accepted : 2006.09.08
  • Published : 2006.10.30
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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.

저자들은 하지 부종과 통증을 주소로 내원한 환자에서 심부 정맥혈전증과 폐암이 있는 환자를 경험하였기에 혈전의 유발 원인이 없는 환자에서 발생하는 특발성 혈전증 환자에서 잠재적 종양에 대한 주의 관찰이 필요할 것으로 보여 문헌 고찰과 함께 더불어 보고하는 바이다.

Keywords

References

  1. Sharp AA. Diagnosis and management of disseminated intravascular coagulation. Br Med Bull 1977:33: 265-72 https://doi.org/10.1093/oxfordjournals.bmb.a071446
  2. Donati MB. Cancer and thrombosis. Haemostasis 1994:24:128-31
  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 https://doi.org/10.1097/00005792-197756010-00001
  4. Trousseau A. Phlegmasia alba dolens. In: Clinique mediciale de l'hotel-dieu de Paris. London: New Sydenham Society:1865. p. 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 1992:69:2712-20 https://doi.org/10.1002/1097-0142(19920601)69:11<2712::AID-CNCR2820691114>3.0.CO;2-H
  6. Bick RL. Cancer-associated thrombosis. N Engl J Med 2003;349:109-11 https://doi.org/10.1056/NEJMp030086
  7. Liu PG, Jacobs JB, Reede D. Trousseau's syndrome in the head and neck. Am J Otolaryngol 1985:6:405-8 https://doi.org/10.1016/S0196-0709(85)80019-3
  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: 4194-9 https://doi.org/10.1200/JCO.2003.05.165
  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 1984:53:2046-52 https://doi.org/10.1002/1097-0142(19840515)53:10<2046::AID-CNCR2820531007>3.0.CO;2-F
  11. Callander N, Rappaport SI. Trousseau's syndrome. West J Med 1993:158:364-71
  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 https://doi.org/10.1006/gyno.1995.1050
  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 2003:349:146-53 https://doi.org/10.1056/NEJMoa025313
  14. van der 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 4 2000:CD002001