A 62-year-old man presents with recurrent migratory superficial thrombophlebitis involving the arm, chest wall, and leg veins over three months. He has lost 8 kg of weight. Contrast CT shows a hypodense mass in the body of the pancreas. The paraneoplastic phenomenon demonstrated here is:

• A Disseminated intravascular coagulation from endothelial activation by IL-6
• B Trousseau syndrome due to tumor-derived procoagulants such as tissue factor ✓
• C Nonbacterial thrombotic endocarditis causing paradoxical venous emboli
• D Hypercoagulability secondary to ectopic erythropoietin secretion

Explanation

Trousseau syndrome is migratory superficial thrombophlebitis classically associated with pancreatic adenocarcinoma, though bronchogenic and other mucin-producing carcinomas also cause it. Tumor cells elaborate tissue factor and other procoagulants that trigger recurrent thromboses at shifting sites. DIC is a distinct consumptive coagulopathy, nonbacterial thrombotic endocarditis produces arterial emboli rather than phlebitis, and erythropoietin excess causes polycythemia, not thrombophlebitis.

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.