A 58-year-old man has recurrent episodes of tender, cord-like induration over different superficial veins of the limbs and trunk over the past 4 months, each episode appearing at a new site while old ones resolve. He also reports 8 kg weight loss and dull epigastric discomfort. Which underlying condition must be actively excluded?

• A Carcinoma of the pancreas ✓
• B Behcet disease
• C Polyarteritis nodosa
• D Systemic lupus erythematosus

Explanation

Migratory superficial thrombophlebitis (Trousseau syndrome) is a classic paraneoplastic marker, classically of mucin-producing adenocarcinomas, with carcinoma of the pancreas being the textbook association. The lesions are recurrent, sterile, and appear at shifting sites. Behcet disease causes superficial thrombophlebitis but is not typically migratory in this pattern and lacks the constitutional features here. Anticoagulation with warfarin is notoriously ineffective; low molecular weight heparin is used, and treatment of the tumour controls the process.

Reference: Bailey & Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.