Trousseau syndrome preceding the diagnosis of colon cancer

Abstract

Trousseau Syndrome (TS) is defined as the occurrence of thromboembolic events prior to or simultaneously with the diagnosis of visceral neoplasia. In cases of multiple thromboembolisms, considering the possibility of TS, a screening for neoplasms may be warranted. We present a case study of a 61-year-old female who presented a neurological deficit. Brain magnetic resonance imaging (MRI) showed multiple hyperintense bihemispheric foci in subcortical and cortical regions involving three different vascular territories in the FLAIR sequence, associated with restricted diffusion inferring cytotoxic edema and indicating that they were all recent ischemic lesions, raising the hypothesis of TS. The patient underwent neoplastic screening with a subsequent diagnosis of colon cancer. TS should be considered when the patient presents thromboembolic events without an established cause. The three-territories-sign (TTS) is an essential radiographic biomarker related to cancer-associated ischemic stroke (CAIS). We propose that our findings be considered for the inclusion of guidelines that determine the investigation of an occult tumor (particularly gastric, pancreatic, lung, and colorectal) in patients who present thrombotic events, especially TTS.