From Complication to Diagnosis: Subclavian Vein Thrombosis as the First Manifestation of Occult Pancreatic Cancer — a Case Report

The tight association between malignancies and thrombosis is well established. Venous thromboembolism may be the first manifestation of an occult cancer in an otherwise healty individual. A 50-year-old woman was applied to our outpatient clinic with complaints of pain and swelling on the right upper extremity for about 2 months. Doppler ultrasound findings of the patient’s right arm showed thrombosis of the right subclavian vein. She was evaluated about hypercoagulable states or mutations leading to hypercoagulability. Hematologic tests showed no abnormalities. Imaging studies were ordered including computed tomography (CT) of the abdomen and thorax to explore an undiagnosed malignancy. Abdominal CT scan findings indicated the expansion in the pancreatic duct. Serum amylase and lipase levels were elevated considerably (10 times the upper limit of the normal levels). She was consulted to the department of gastroenterology and transferred with diagnosis of pancreatitis. At follow-up, she was diagnosed with pancreatic carcinoma and died 3 months after the diagnosis.