One hundred years have passed since Trousseau first made the observation that thrombosis may be found in association with cancer.1 Episodes of embolism 2 and thrombophlebitis,3-5 may precede clinical evidence of certain tumors, and nonbacterial thrombotic endocarditis is sometimes associated with neoplastic disease.6 The thrombophlebitis seen in patients with cancer is characterized as recurrent and migrating 7,8 with involvement of multiple sites, including the upper trunk and arms.4,7,9 Anticoagulation is usually ineffective in its control.3,4 Tumors of the lung, ovary, stomach, and pancreas are believed to be most commonly associated with a thrombotic tendency.4-10
The incidence of thrombophlebitis in patients with malignant disease is low,11,12 and contributory factors often play a role in increasing the susceptibility of the cancer patient to the development of thromboses.12 Conversely, only 3% to 5% of patients with evidence of thrombosis had cancer.5,13
Since it is