Isolated vein thrombophlebitis is uncommonly associated with internal malignant disease. Multiple lesion "migratory" superficial thrombophlebitis is much more often seen in association with cancer, and when this syndrome is present, the patient should be examined carefully for occult malignant disease.
The association of peripheral thrombophlebitis (phlebothrombosis) with gastric carcinoma was noted by Trousseau in the 19th century. Migratory superficial thrombophlebitis as a marker for cancer has been confirmed and the association has been extended to include tumors of pancreas, prostate, lung, liver, bowel, gallbladder and ovary, as well as to lymphoma and leukemia.
The "migratory" nature of the thrombophlebitis probably relates to a generalized hypercoagulable state where clots form and extend along a vessel.
Mondor's disease is thrombophlebitis of the anterior chest wall. Presenting as a tender or non-tender cord, usually benign, it can be associated with primary or recurrent breast cancer.
Patients with deep venous thrombosis younger than 50 years, appear to have a very significant risk of occult cancer (relative risk 19.0) and thus should have an appropriately thorough examination and laboratory investigation. In that study, those at greatest risk for cancer had a low hemoglobin and an eosinophilia.
- In addition to treatment of the cancer, anticoagulants can be useful.
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