# Trousseau’s Syndrome With Severe Visual Loss As the Initial Symptom

## TL;DR

A 70-year-old man with pancreatic cancer experienced severe vision loss due to Trousseau’s syndrome, highlighting the need to consider this condition in cancer patients with visual symptoms.

## Contribution

This case report highlights Trousseau’s syndrome presenting with severe visual loss as an initial symptom in a cancer patient.

## Key findings

- The patient showed retinal pigment epithelial atrophy and cotton-wool spots on fundus examination.
- Brain MRI revealed occipital lobe infarction, and elevated D-dimer levels confirmed Trousseau’s syndrome.
- Visual loss in cancer patients should prompt evaluation for Trousseau’s syndrome and coagulability testing.

## Abstract

There are limited reports on patients with Trousseau syndrome, a condition characterized by hypercoagulability associated with malignant tumors, initially manifesting with reduced visual function. We present a case of a patient who experienced bilateral vision loss and was subsequently diagnosed with Trousseau's syndrome following examination and investigations. A 70-year-old man, undergoing chemotherapy for advanced pancreatic cancer, reported decreased visual acuity in both eyes. A dilated fundus examination revealed retinal pigment epithelial atrophy in the posterior pole and cotton-wool spots. Optical coherence tomography exhibited partial disruption of the ellipsoid zone in the parafoveal region, and full-field electroretinogram results were subnormal, although the macular retinal structure was preserved. Brain magnetic resonance imaging (MRI) detected occipital lobe infarction. Elevated coagulability markers, including D-dimer (5.5μg/mL), led to the diagnosis of Trousseau's syndrome. In cases where patients with malignant tumors present with profound visual loss, considering the possibility of Trousseau's syndrome and conducting assessments of brain function and coagulability is crucial for accurate diagnosis and appropriate management.