Managing Acute Limb Swelling In DVT With Adenocarcinoma

Deep vein thrombosis (DVT) is a potentially life-threatening condition often associated with malignancies, particularly adenocarcinomas. Malignancy-associated DVT is commonly a manifestation of Trousseau’s syndrome, characterized by a hypercoagulable state driven by tumor-related pro-inflammatory and pro-thrombotic mechanisms. Gallbladder adenocarcinoma, a rare and aggressive malignancy, predisposes patients to thromboembolic events, often serving as an early indication of the disease. A patient presented with progressive left lower limb swelling, low-grade intermittent fever, and localized inflammation over three months. Clinical examination revealed a tender, warm swelling in the subcutaneous plane without ulceration or discoloration. Laboratory findings showed an elevated D-dimer level of 5.0 µg/mL, with other parameters within normal limits. Doppler ultrasonography confirmed extensive DVT in the left lower limb, involving the great saphenous vein. PET-CT imaging identified gallbladder adenocarcinoma with metastasis to the liver, peritoneum, and lymph nodes. This case underscores the significant association between unprovoked DVT and malignancy, emphasizing the importance of advanced imaging techniques like PET-CT in diagnosing underlying malignancies and guiding timely interventions.