[Trousseau's syndrome: a combination of cancer and hypercoagulability]

Trousseau's syndrome (TS) is a combination of cancer and hypercoagulability, considered to be a chronic disseminated intravasal coagulation which leads to venous thromboembolism and arterial thrombosis in cancer patients. In TS, thrombosis results from an activation of hemostasis by different mechanisms. Cardioembolic stroke is the most common type that occurs in patients with malignancy, partly due to cancer-related hypercoagulability. The classical presentation of TS comprises multiple bilateral ischemic brain lesions in both supra- and infratentorial regions of the brain. TS occurs most commonly in patients with lung, pancreas, breast and colon cancer, usually mucin-producing cancer. TS manifests most commonly within 30 days of occurrence of cancer symptoms or longer in local and metastatic cancer, respectively. Standard treatment of TS is low molecular weight heparin, whereas in recent years non-vitamin K oral anticoagulants have been tested and not shown better effect so far, but further studies are required.