Journal of Clinical & Experimental OncologyISSN: 2324-9110

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Clinical Image, J Clin Exp Oncol Vol: 5 Issue: 1

Cotton Wool Spots in Trousseau’s Syndrome

Valeria Kheir and François-Xavier Borruat*
Jules-Gonin Eye Hospital, Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland
Corresponding author : François-Xavier Borruat
Jules-Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland
Tel: +41 21 626 8660; Fax: +41 21 626 8666
E-mail: [email protected]
Received: February 12, 2016 Accepted: February 23, 2016 Published: February 28, 2016
Citation: Kheir V, Xavier Borruat F (2015) Cotton Wool Spots in Trousseau’s Syndrome. J Clin Exp Oncol 5:1. doi:10.4172/2324-9110.1000152

Abstract

Trousseau’s syndrome is a paraneoplastic disorder characterized by a hypercoagulable state inducing either migratory superficial thrombophlebitis or arterial emboli from a nonbacterial thrombotic endocarditis. Cotton wool spots (CWS) are usually asymptomatic and represent small areas of retinal infarction. A 69 year-old man was investigated for multiple cerebral and cerebellar thromboembolic events and was found to harbour a metastatic pancreatic carcinoma.

Keywords: Cotton-wool spots; Retinal hemorrhages; Systematic fundus; Trousseau’s syndrome

Keywords

Cotton-wool spots; Retinal hemorrhages; Systematic fundus; Trousseau’s syndrome
Trousseau’s syndrome is a paraneoplastic disorder characterized by a hypercoagulable state inducing either migratory superficial thrombophlebitis or arterial emboli from a nonbacterial thrombotic endocarditis. Cotton wool spots (CWS) are usually asymptomatic and represent small areas of retinal infarction. A 69 year-old man was investigated for multiple cerebral and cerebellar thromboembolic events and was found to harbour a metastatic pancreatic carcinoma. Anticoagulation and chemotherapy were initiated. Visual acuity was 20/20 OU with a left homonymous hemianopsia. Fundus examination revealed multiple asymptomatic CWS at the posterior pole of both eyes, which topography changed over the next five months (Figure 1). Cerebral ischemic events occur in Trousseau’s syndrome, as did our patient present, but no reports of retinal ischemia have been published yet. Retinal hemorrhages and CWS are usually asymptomatic and transient, and may thus be undetected. Systematic fundus examination should be performed in patients with Trousseau’s syndrome.
Figure 1: Examination revealed multiple asymptomatic Cotton-wool spots at the posterior pole of both eyes, which topography changed.

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