Trousseau's sign in the left internal jugular vein in gastric cancer

ABSTRACT

A 24-year-old woman came with complaints of upper abdominal swelling for the last 6 months, early satiety associated with loss of appetite and weight for 3 months, abdominal pain for the last 1 month, and vomiting for the last 4 days. Abdominal examination revealed a centrally placed solid swelling in the epigastric region with mild tenderness. Abdominal ultrasound and contrast-enhanced computed tomography (CECT) abdomen showed multiple liver secondaries and diffuse circumferential gastric wall thickening and enlarged peripancreatic and periportal nodes [Figure 1]. Ultrasound of neck and Doppler and CECT neck showed partial thrombus in the left internal jugular vein thrombosis (IJVT) proximal to its origin for a length of about 1.7 cm [Figure 2]a and [Figure 2]b. Upper gastrointestinal scopy showed ulceroproliferative growth in the body, antrum, and pylorus region with features of infiltrating adenocarcinoma of poorly differentiated diffuse type on biopsy.