Trousseau's syndrome caused by bladder cancer producing granulocyte colony-stimulating factor and parathyroid hormone-related protein: A case report

Kato,Tomonori; Yasuda,Kenji; Iida,Hiroaki; Watanabe,Akihiko; Fujiuchi,Yasuyoshi; Miwa,Shigeharu; Imura,Johji; Komiya,Akira

doi:10.3892/ol.2016.5152

November-2016 Volume 12 Issue 5

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November-2016 Volume 12 Issue 5

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Case Report

Trousseau's syndrome caused by bladder cancer producing granulocyte colony-stimulating factor and parathyroid hormone-related protein: A case report

Authors:
- Tomonori Kato
- Kenji Yasuda
- Hiroaki Iida
- Akihiko Watanabe
- Yasuyoshi Fujiuchi
- Shigeharu Miwa
- Johji Imura
- Akira Komiya
View Affiliations / Copyright

Affiliations: Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama 930‑0194, Japan, Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama 930‑0194, Japan
Pages: 4214-4218
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Published online on: September 20, 2016

https://doi.org/10.3892/ol.2016.5152
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Abstract

The present study reports a rare case of bladder cancer that caused Trousseau's syndrome, a malignancy-associated hypercoagulative state leading to venous or arterial thrombosis. A 38‑year‑old Japanese female patient experienced a sudden onset of visual field defects and lower limb weakness. Cerebral magnetic resonance imaging revealed multi‑regional hypointense areas compatible with acute cerebral infarction. Despite the repeated administration of anticoagulant treatment with heparin, the condition could not be adequately controlled and thromboembolic events occasionally recurred. Several tumor markers, including carbohydrate antigen 19‑9, cancer antigen 125, carcinoembryonic antigen, cytokeratin 19 fragment and squamous cell carcinoma antigen levels, were elevated. Consequently, computed tomography scans were performed, which revealed a massive bladder tumor with multiple bone and lymph node metastases. The patient also exhibited other paraneoplastic disorders, including leukocytosis due to granulocyte colony‑stimulating factor (G‑CSF) production, and hypercalcemia due to parathyroid hormone‑related protein (PTHrP) production. Transurethral resection of the bladder tumor was performed, and the tumor was pathologically confirmed as urothelial cell carcinoma. Immunohistochemical testing revealed positive staining for G‑CSF and PTHrP. Despite undergoing gemcitabine/cisplatin‑based systemic chemotherapy, the disease developed rapidly and the patient succumbed to the disease within 3 months of initial symptoms. The present case indicates that occult visceral malignancy should be considered in patients with unexplained thromboembolism.

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1	Varki A: Trousseau's syndrome: Multiple definitions and multiple mechanisms. Blood. 110:1723–1729. 2007. View Article : Google Scholar : PubMed/NCBI
2	Bick RL: Cancer-associated thrombosis. N Engl J Med. 349:109–111. 2003. View Article : Google Scholar : PubMed/NCBI
3	el-Shami K, Griffiths E and Streiff M: Nonbacterial thrombotic endocarditis in cancer patients: Pathogenesis, diagnosis and treatment. Oncologist. 12:518–523. 2007. View Article : Google Scholar : PubMed/NCBI
4	Tesselaar ME, Romijn FP, Van Der Linden IK, Prins FA, Bertina RM and Osanto S: Microparticle-associated tissue factor activity: A link between cancer and thrombosis? J Thromb Haemost. 5:520–527. 2007. View Article : Google Scholar : PubMed/NCBI
5	Masubuchi H, Maeno T, Uchida M, Kono S, Suzuki M, Takemura M, Yamaguchi A, Yamaguchi K, Kanbe M, Kitahara S, et al: A case of Trousseau syndrome caused by pulmonary adenocarcinoma that was controlled for one year and 10 months with thrombosis treatment using an EGFR tyrosine kinase inhibitor and chemotherapy. Respir Med Case Rep. 15:101–105. 2015.PubMed/NCBI
6	Albright F: Case records of the Massachusetts General Hospital (case 27461). N Engl J Med. 225:789–791. 1941.
7	Wolchok JD, Herr HW and Kelly WK: Localized squamous cell carcinoma of the bladder causing hypercalcemia and inhibition of PTH secretion. Urology. 51:489–491. 1998. View Article : Google Scholar : PubMed/NCBI
8	Dvorak HF: Thrombosis and cancer. Hum Pathol. 18:275–284. 1987. View Article : Google Scholar : PubMed/NCBI
9	Wahrenbrock M, Borsig L, Le D, Varki N and Varki A: Selectin-mucin interactions as a probable molecular explanation for the association of Trousseau syndrome with mucinos adenocarcinomas. J Clin Invest. 112:853–862. 2003. View Article : Google Scholar : PubMed/NCBI
10	Shao B, Wahrenbrock MG, Yao L, David T, Coughlin SR, Xia L, Varki A and McEver RP: Carcinoma mucins trigger reciprocal activation of platelets and neutrophils in a murine model of trousseau syndrome. Blood. 118:4015–4023. 2011. View Article : Google Scholar : PubMed/NCBI
11	Carraway KL, Fregien N, Carraway KL III and Carraway CA: Tumor sialomucin complexes as tumor antigens and modulators of cellular interactions and proliferation. J Cell Sci. 103:299–307. 1992.PubMed/NCBI
12	Varki NM and Varki A: Heparin inhibition of selectin-mediated interactions during the hematogenous phase of carcinoma metastasis: Rationale for clinical studies in humans. Semin Thromb Hemost. 28:53–66. 2002. View Article : Google Scholar : PubMed/NCBI
13	Tachihara M, Nikaido T, Wang X, Sato Y, Ishii T, Saito K, Sekine S, Tanino Y, Ishida T and Munakata M: Four cases of Trousseau's syndrome associated with lung adenocarcinoma. Intern Med. 51:1099–1102. 2012. View Article : Google Scholar : PubMed/NCBI
14	Jovin TG, Boosupalli V, Zivkovic SA, Wechsler LR and Gebel JM: High titers of CA-125 may be associated with recurrent ischemic strokes in patients with cancer. Neurology. 64:1944–1945. 2005. View Article : Google Scholar : PubMed/NCBI
15	Sack GH Jr, Levin J and Bell WR: Trousseau's syndrome and other manifestations of chronic disseminated coagulopathy in patients with neoplasms: Clinical, pathologic, and therapeutic features. Medicine (Baltimore). 56:1–37. 1977. View Article : Google Scholar : PubMed/NCBI
16	Walsh-McMonagle D and Green D: Low-molecular-weight heparin in the management of Trousseau's syndrome. Cancer. 80:649–665. 1997. View Article : Google Scholar : PubMed/NCBI
17	Kumar AK, Satyan MT, Holzbeierlein J, Mirza M and Van Veldhuizen P: Leukemoid reaction and autocrine growth of bladder cancer induced by paraneoplastic production of granulocyte colony-stimulating factor-a potential neoplastic marker: A case report and review of the literature. J Med Case Rep. 8:1472014. View Article : Google Scholar : PubMed/NCBI
18	Hirasawa K, Kitamura T, Oka T and Matsushita H: Bladder tumor producing granulocyte colony-stimulating factor and parathyroid hormone-related protein. J Urol. 167:21302002. View Article : Google Scholar : PubMed/NCBI