[Superficial migratory thrombophlebitis: a clinical and histologic review of 8 cases]

Superficial migratory thrombophlebitis (SMT) or thrombophlebitis migrans is characterized by recurrent episodes of localized thrombosis of the superficial veins in the limbs and trunk. It has been associated with various systemic diseases that should be taken into consideration when assessing the patient.

Between 1997 and 2007, 8 patients with SMT were seen at Hospital General Universitario de Valencia in Valencia, Spain. We review the clinical features and histopathology, along with the associated diseases.

The most common clinical presentation was with painful nodules mimicking erythema nodosum on the lower extremities. Other sites were on the abdomen and trunk. Only in 1 case was SMT diagnosed clinically. In other cases, the clinical diagnoses were cellulitis, lymphangitis, nodular vasculitis, and panarteritis nodosa. The histologic characteristics were compatible with superficial thrombophlebitis, and orcein staining revealed the internal elastic lamina to be absent in all cases. No evidence of an occult tumor was found in any of the cases. Two cases had a history of Buerger disease and in another the condition presented in association with a fever of unknown origin.

The possible association of SMT with systemic diseases, including cancer, makes its diagnosis important. In our case series we did not find evidence of associated disease in the majority of cases. However, since cancer can manifest months and even years after the appearance of SMT, follow-up is necessary in these patients.