Superficial Venous Thrombosis in Atypical Locations

Superficial venous thrombosis (SVT) is an inflammation of the venous wall with subsequent
secondary thrombus formation. In the majority of cases, it affects the superficial
venous system of the lower extremities. SVT which appears in functionally and structurally
normal veins without varicose changes is a heterogeneous group of diseases in which
different etiopathogenetic mechanisms are present with varying expressions of inflammatory
and thrombotic processes. Trousseau’s syndrome is a rare variant of venous thrombosis
that is characterised by recurrent, migratory thrombosis in superficial veins and
in uncommon sites, such as the upper extremities, trunk, and chest wall. Superficial migratory
thrombophlebitis is associated with systemic diseases like hypertension, Buerger
syndrome/thrombophlebitis obliterans, hypercoagulable conditions like protein C and S deficiencies,
lupus anticoagulant, factor XII deficiency, systemic inflammatory diseases, Behcet
disease and cancer. Mondor disease describes a syndrome of sclerosing superficial thrombophlebitis
of the veins of the anterior thoracic wall. The most commonly involved vessel
is the superior epigastric vein, producing a palpable cord in the inferior outer quadrant
of the breast. It has often been linked to local trauma, including repetition injury or direct
injury associated with surgery. In addition to the diagnosis of superficial venous thrombosis
using ultrasound, more extensive diagnostic procedures in order to look for a systemic
procoagulant state are often needed, since underlying diseases are important for
the treatment of SVT in an atypical location.