Yusri Arif

• The Trousseau sign of malignancy is a sign found in certain cancers, especially adenocarcinomas of the pancreas and lung that is associated with venous thrombosis and hypercoagulability.
• It may be related to factors secreted by the tumors, in particular a circulating pool of cell-derived tissue factor-containing microvesicles.
• Armand Trousseau first described this finding in the 1860s; he later found the same sign in himself, was subsequently diagnosed with gastric cancer and died soon thereafter.

1. Meralgia: pain in the thigh
2. Melalgia: pain in the limbs
3. Menalgia: pain accompanying menstruation
4. Myalgia: pain in a muscle or muscles
5. Myelalgia: pain in the spinal cord
6. Neuralgia: pain extending along the course of one or more nerves
7. Paralgia: paralgesia; any condition marked by abnormal and painful sensations; a painful parasthesia
8. Telalgia: referred pain
9. Tenalgia: pain in a tendon
10. Uteralgia: hysteralgia; pain in the uterus

1. A painful mononeuropathy of the lateral femoral cutaneous nerve (LFCN), commonly due to focal entrapment of this nerve as it passes through the inguinal ligament.
2. Rarely, it has other etiologies such as direct trauma, stretch injury, or ischemia. It typically occurs in isolation. 
3. The clinical history and examination is usually sufficient for making the diagnosis. It causes pain, tingling and numbness in the anterolateral thigh. (It is a purely sensory nerve and has no motor component)
4. The diagnosis can be confirmed by nerve conduction studies. 
5. Treatment is usually supportive. (Weight loss if appropriate)
6. Steroid injection or surgical decompression may be helpful in some cases.

Key facts

• Caused by a subcutanenous fungal infection
• May be caused by different colours of spores but the clinical picture is remarkably uniform.

Clinicopathological features

• The first sign is a painless swelling in the foot that gradually develops multiple sinuses and sometimes discharges purulent material containing grains of the fungus
• Local spread may occur if the primary infection is not treated leading to deep tissue infection, e.g. fungal osteomyelitis
• Systemic fungal is rare

Diagnosis

• Microscopy of discharge shows fungal hyphae

Medical treatment

• Dapsone, co-trimoxazole, streptomycin, and rifampicin are used either alone or in combination

Surgical treatment

• All the affected area, including all sinuses, must be excised once treatment has begun
• Amputation is occasionally necessary if deep esteomyelitis has occured