Trousseaus Syndrome in Cholangiocarcinoma: The Risk of Making the Diagnosis

Blum, Matthew F.; Vincent, Y.; Betbadal, Anthony; Raju, Rajeeva; Packer, Clifford D.

doi:10.3121/cmr.2015.1304

Cited by 11 publications

(16 citation statements)

References 20 publications

(14 reference statements)

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“…Tumors associated with Trousseau's syndrome are usually mucin-producing adenocarcinomas derived from visceral organs. However, few studies have reported an association between cholangiocarcinoma and thromboembolism [3,7,8]. The prognosis is extremely poor in patients with Trousseau's syndrome related to primary cholangiocarcinoma [3,7,8], which was first reported by Ching in 1991 [7].…”

Section: Discussionmentioning

confidence: 99%

“…However, few studies have reported an association between cholangiocarcinoma and thromboembolism [3,7,8]. The prognosis is extremely poor in patients with Trousseau's syndrome related to primary cholangiocarcinoma [3,7,8], which was first reported by Ching in 1991 [7]. Eleven cases of Trousseau's syndrome developed in intrahepatic cholangiocarcinoma have been reported in English [3,7,8].…”

Section: Discussionmentioning

confidence: 99%

“…The prognosis is extremely poor in patients with Trousseau's syndrome related to primary cholangiocarcinoma [3,7,8], which was first reported by Ching in 1991 [7]. Eleven cases of Trousseau's syndrome developed in intrahepatic cholangiocarcinoma have been reported in English [3,7,8]. Only three patients of eleven survived for more than 3 months, and there was no patient who underwent liver resection.…”

Section: Discussionmentioning

confidence: 99%

“…While the precise mechanism underlying Trousseau's syndrome remains unknown, hypercoagulability might be initiated by mucins produced by an adenocarcinoma [4]. Intriguingly, Trousseau's syndrome is rarely reported in patients with cholangiocarcinoma [3]. We herein report the case of a patient with intrahepatic cholangiocarcinoma who presented with Trousseau's syndrome manifesting as thromboembolic lesions in multiple organs including the brain and was treated with right hepatectomy followed by systemic chemotherapy.…”

Section: Introductionmentioning

confidence: 93%

“…Armand Trousseau was the first to describe the association of thrombotic episodes with an underlying malignancy [1][2][3][4][5]. Recent definitions restrict Trousseau's syndrome to unexplained thrombotic events that occur before or concomitantly with the presentation of visceral malignancies [3]. The prognosis of Trousseau's syndrome, which is often diagnosed in patients with terminal cancer, is extremely poor.…”

Section: Introductionmentioning

confidence: 99%

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A case of Trousseau’s syndrome due to intrahepatic cholangiocarcinoma with an extremely high level of CA19-9

et al. 2020

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Background: Trousseau's syndrome is a cancer-associated thrombosis. Trousseau's syndrome with cholangiocarcinoma is a rare condition with poor prognosis. Case presentation: A 59-year-old female was admitted to our hospital with abdominal pain, headache, and nausea. Abdominal enhanced computed tomography revealed liver tumor, splenic infarction, and bilateral renal infarction. Multiple acute cerebral infarctions were also detected by magnetic resonance imaging. Her preoperative serum levels of carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) were > 120,000 U/mL and 589.6 ng/mL, respectively, which were extremely high. Histopathology after right hepatectomy revealed moderately differentiated adenocarcinoma consistent with intrahepatic cholangiocarcinoma. Her serum levels of CA19-9 were trending down to 9029.2 and 2659.8 U/mL at 1 and 3 weeks after surgery, respectively. However, at 7 weeks after surgery, her CA19-9 levels increased in the presence of positive imaging findings in the remnant liver, hilar lymph nodes, and peritoneal cavity. The initiation of combination chemotherapy including gemcitabine and cisplatin had a significant effect. The patient was doing well at 6 months after the surgery. Conclusion: This rare case of Trousseau's syndrome due to cholangiocarcinoma suggests that extremely high CA19-9 levels might be a pathogenic factor of this syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A case of Trousseau’s syndrome due to intrahepatic cholangiocarcinoma with an extremely high level of CA19-9

et al. 2020

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Trousseau syndrome with intrahepatic cholangiocarcinoma that could be removed radically after endovascular treatment: Report of a case

et al. 2020

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Background Trousseau syndrome is a poor prognosis. We report a case of Trousseau syndrome treated by radical resection after endovascular treatment. Case A 59‐year‐old woman presented to our department reporting spontaneous dizziness and pain of the upper abdomen. Magnetic resolution imaging (MRI) showed shower embolization of Brain. Contrast‐enhanced computer tomography (CT) showed renal infarction and splenic infarction, and a tumor was observed in the retrohepatic area. On day 9, sudden right side joint prejudice, neglect of left half space, and left hemiplegia were observed. MRI revealed obstruction of the right middle cerebral artery (MCA) perfusion zone. On the same day, endovascular treatment was performed and reperfusion was obtained. We decided on a radical surgery policy because there were a primary lesion and a high risk of new embolism, and no metastasis was seen. Discussion Trousseau syndrome generally has a poor prognosis, but active treatment should be considered as an option when we can expect the recovery of function.

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Predictors for thromboembolism in patients with cholangiocarcinoma

Pfrepper

Knödler²,

Schorling³

et al. 2021

J Cancer Res Clin Oncol

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Background Patients with cancer are at increased risk of thromboembolic events contributing significantly to cancer-related morbidity and mortality. Because cholangiocarcinoma is a rare type of cancer, the incidence of thromboembolism in this patient population is not well defined. Methods Patients with cholangiocarcinoma treated at the University Cancer Center Leipzig between January 2014 and December 2018 were analyzed retrospectively regarding the incidence of arterial and venous thromboembolism. Results A total of 133 newly and consecutively diagnosed patients were included, of whom 22% had stage IV disease. Thromboembolism was diagnosed in 39 (29.3%), with 48% of the events occurring between 60 days prior and 30 days after the initial diagnosis. Arterial thrombosis accounted for 19% and portal venous thrombosis for 33% of the events, while the rest of events occurred in the non-portal venous system. In multivariable analysis, an ONKOTEV score ≥ 2 was the only independent predictor for thromboembolism. Serum CA 19-9 was available in 87 patients (65.4%). In this subgroup, CA 19-9 above the median of 97.7 U/ml and vascular or lymphatic compression were independent predictors for thromboembolism in the first year and CA 19-9 alone remained a significant predictor over the whole observation period. An ONKOTEV score ≥ 2 and increasing age were predictors of survival. Conclusions A very high thromboembolic risk was observed in cholangiocarcinoma, comparable to the risk situation in pancreatic and gastric cancer. The ONKOTEV score and serum CA 19-9 are independent predictors of thromboembolic events. Prospective validation of our observations in this patient population is warranted.

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Trousseaus Syndrome in Cholangiocarcinoma: The Risk of Making the Diagnosis

Cited by 11 publications

References 20 publications

A case of Trousseau’s syndrome due to intrahepatic cholangiocarcinoma with an extremely high level of CA19-9

A case of Trousseau’s syndrome due to intrahepatic cholangiocarcinoma with an extremely high level of CA19-9

Trousseau syndrome with intrahepatic cholangiocarcinoma that could be removed radically after endovascular treatment: Report of a case

Predictors for thromboembolism in patients with cholangiocarcinoma

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