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Thrombophlebitis Migrans Warning Signal Of Malignancy

When thrombophlebitis migrans was first described with its serious associations by French doctor Armand Trousseau around 1860s clotting cascades were not understood as they are today.

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But he had seen a series of people with superficial clots later presenting with various cancers.

Serendipitously he suffered the condition himself in his 60s.  Not long after he died from his stomach cancer.

Therefore this is not something distinctly associated with varicose veins as such.

But because of its health implications I am covering it here.

Description

Essentially a series of surface vein clots occur at different areas over time.  They become inflamed.  Then settle.

Stylised clotting illustration as occurring with thrombophlebitis migransIllustration of the clotting process

Unusual areas can become involved like vessels on the chest wall and arms. 

In other circumstances this can occur at times after intravenous medication is administered through those points.

But true thrombophlebitis migrans occurs without such provoking factors.

With Varicose Veins

With the high percentage of people suffering from varicose veins, pure chance will mean a number of these more serious situations will occur in people with varicose problems.

Clotting Disorders

In other hyper-coagulable (or high clotting) states adverse blood chemistries could cause this too.  Not usually on the upper body areas.

The majority of such interconnections will be recognised by various blood tests designed to reveal such people. 

Usually a genetic link is present.  Although someone in the line has to be the sentinel or first case.

We know there are probably about a quarter of people presenting with increased clotting tendencies who have normal blood chemistry.  At least with our current testing knowledge.

Over time maybe more factors may be found that can be tested for.  But at present there is always going to be this unmarked group.

Repeated Clotting Episodes

Example of localised inflammation as occurs with thrombophlebitis migrans

If you have a history of repeated inflamed surface clots in varying places it is important to exclude thrombophlebitis migrans. 

Especially with its problem associations.

As I noted it was described way back in the nineteenth century. 

There have been ongoing papers on its occurrence over the years as illustrated by this surgical one from 1950.

It can involve more than just superficial veins.  At times even some arteries can be affected.

Cancer And Thrombophlebitis Migrans

It is well established it is strongly indicative of underlying cancer in the body. 

It may start well before the provoking cancer is easily detectable.

In particular gliomas and adenocarcinomas of the pancreas, stomach and lung are associated with this clotting disorder.

Gliomas are tumours of nerve tissue of the brain and spinal cord.

Adenocarcinomas arise from secreting cells in the tissue of origin sites. 

Although not yet demonstrated it is felt some of these secretions cause the observed increased blood clotting.

Detection Options

A number of blood-borne markers may help detect such tumours’ presence before they can be physically shown.

With its serious implications thrombophlebitis migrans should be thoroughly investigated. 

Any associated tumour should be dealt with up front.

All this well before you have any varicose vein problem treated.

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