A 62-year-old man presents with recurrent episodes of migratory superficial thrombophlebitis affecting the arms, legs, and neck over several weeks. Evaluation reveals a mass in the head of the pancreas with biopsy confirming adenocarcinoma. This thrombotic paraneoplastic phenomenon is best explained by:

• A Tumor mucins activating platelets through selectin-mediated interactions ✓
• B Tumor-derived tissue factor pathway inhibitor causing a procoagulant state
• C Antiphospholipid antibodies produced by the malignant cells
• D Deficiency of antithrombin III induced by tumor necrosis

Explanation

Trousseau syndrome, classically seen with pancreatic and other mucin-producing adenocarcinomas, results from tumor-derived mucins that bind selectins on platelets and endothelium, triggering widespread platelet-rich microthrombi and recurrent migrating venous thromboses. The key distractor is option D: antithrombin deficiency is not induced by the tumor, and this is not an inherited or acquired coagulation factor problem but a platelet activation state driven by mucin glycoproteins.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.