Abstract
In patients with Trousseau syndrome, atypical cerebral infarction is caused by enhanced blood clotting as a paracancerous symptom. We herein report a case with Trousseau syndrome caused by primary small bowel carcinoma. A 47-year-old woman complaining of paralysis of the left upper extremity and dysarthria was admitted to our hospital. Computed tomography (CT) and magnetic resonance imaging revealed multiple cerebral infarctions. Mild anemia was also found. Abdominal CT revealed localized wall thickning of the small bowel and swelling of the mesenteric lymph nodes. An ulcerated circumferential tumor was identified in the upper jejunum by capsule endoscopy and small bowel endoscopy. Using biopsy specimens from the tumor, the lesion was confirmed as adenocarcinoma. In the laparotomy, the tumor was located in the upper jejunum, invading into the right side colon. Partial resection of the jejunum and right hemicolectomy with lymph node dissection was carried out. In the resected specimens, the lesion was a tubular adenocarcinoma with metastasis to four lymph nodes. Postoperative course was uneventful and the patient was discharged on the 12th postoperative day. Her neurological symptoms were resolved within 10 days, and she is disease-free six months after the operation.
