What Is Trousseau's Sign? Where Does Its Name Come From?

Also known as Trousseau syndrome, Trousseau's sign of cancer (Trousseau’s sign of malignancy) refers to a paraneoplastic process, usually associated with a cancer of unknown origin, that manifests as recurrent, migratory thromboses (blockages of blood vessels).

Trousseau's sign of cancer is different from the “obstetrician's hand” appearance, also named after Dr. Trousseau, that occurs in people with low calcium when pressure is applied to the arm with a blood pressure cuff; in fact, this hand posture is what first comes to mind when Trousseau's sign is mentioned.

Note: Although the Turkish word “belirti” (symptom) is often used in our language, it is more accurate to translate “sign” as “işaret” or “bulgu” (sign or finding). However, this article uses the customary word “belirti.”

Paraneoplastic syndromes are a general name for a range of diseases that occur very rarely when cancer triggers the immune system through alternative pathways. A syndrome is a collection of findings that seem unrelated but appear as a single condition when they occur together. A paraneoplastic syndrome is not directly related to the tumor or its spread to other tissues (metastasis); it results from tumor cells secreting biologically active substances such as hormones or cytokines. Substances released by the tumor then trigger a range of complaints and symptoms. These complaints can involve many systems: endocrine (hormonal), nervous, musculoskeletal, cardiovascular, skin, blood cells, gastrointestinal or renal.

Stomach, pancreatic, prostate, colon and lung cancers are often diagnosed at a late/advanced stage. Trousseau's sign of cancer classically appears while investigating thrombophlebitis (clotting within a vein) of unexplained cause; this is usually later found to be pancreatic cancer. Over time, the term has been used for various conditions associated with cancer-related excessive clotting , including occult cancers commonly presenting with uncomplicated deep vein thrombosis (DVT) of the leg. Clots may occur in typical locations such as the legs or in less common areas such as blood vessels of the arms, neck or abdomen.

The History of the Name Trousseau

The doctor after whom Trousseau's sign of cancer is named, Dr. Armand Trousseau, was born in Tours, France, in 1801. He completed his medical education in Paris in 1825 and began working as a physician at St. Antoine Hospital in 1839. He later continued practicing at Hotel Dieu.

Dr. Trousseau was known as an observant clinician and a prolific author. He is believed to have been the first physician to perform a tracheotomy (an operation to open the windpipe), in 1831, and the first to describe hemochromatosis (a disorder caused by excess iron accumulating in the body), in 1865. He also described types of epilepsy, difficulty walking in Parkinson's disease and Trousseau's sign for latent tetany (spasms caused by calcium deficiency).

Dr. Trousseau gave a series of lectures describing the cancer-associated thrombosis phenomenon that would one day bear his name. He described an association between “painful white inflammation” and spontaneous clotting in patients with uterine and visceral cancers and advanced tuberculosis.

Finally, Dr. Trousseau diagnosed his own condition and died of stomach cancer in 1867, 2 years later.