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. 1987 Jul;206(1):62–68. doi: 10.1097/00000658-198707000-00010

Digital ischemia as a manifestation of malignancy.

L M Taylor Jr, M G Hauty, J M Edwards, J M Porter
PMCID: PMC1492931  PMID: 3606232

Abstract

The association of malignancy with thrombotic disorders of the arterial and venous systems is well described. To date, however, there are only 23 published case reports of digital gangrene associated with malignancy. During a prospective evaluation of over 700 patients with finger ischemia, there were five patients with finger gangrene associated with malignancy. Detailed clinical and laboratory evaluation, including detailed immunologic survey and hand angiography, allowed establishment of the precise mechanisms responsible for vascular occlusions in each patient. Three mechanisms were identified: arteritis, hyperviscosity, and hypercoagulability. Digital gangrene associated with malignancy is a rare condition, the mechanism for which can be deduced by careful diagnostic evaluation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrasch R. H., Bardana E. J., Jr, Porter J. M., Pirofsky B. Digital ischemia and gangrene preceding renal neoplasm. An association with sarcomatoid adenocarcinoma of the kidney. Arch Intern Med. 1976 Apr;136(4):486–488. [PubMed] [Google Scholar]
  2. BOHROD M. G. Plasmacytosis and cryoglobulinemia in cancer. J Am Med Assoc. 1957 May 4;164(1):18–21. doi: 10.1001/jama.1957.02980010020005. [DOI] [PubMed] [Google Scholar]
  3. Bartholomew L. G., Schutt A. J. Systemic syndromes associated with neoplastic disease including cancer of the colon. Cancer. 1971 Jul;28(1):170–174. doi: 10.1002/1097-0142(197107)28:1<170::aid-cncr2820280134>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  4. Case 4. Carcinoma of the OEesophagus and Raynaud's Disease. Can Med Assoc J. 1920 Jul;10(7):670–671. [PMC free article] [PubMed] [Google Scholar]
  5. DOMZ C. A., CHAPMAN C. G. Pseudo-Raynaud's: cryoglobulinemia secondary to occult neoplasm. Calif Med. 1961 Dec;95:391–393. [PMC free article] [PubMed] [Google Scholar]
  6. Friedman S. A., Bienenstock H., Richter I. H. Malignancy and arteriopathy. A report of two cases. Angiology. 1969 Mar;20(3):136–143. doi: 10.1177/000331976902000304. [DOI] [PubMed] [Google Scholar]
  7. Gorevic P. D., Kassab H. J., Levo Y., Kohn R., Meltzer M., Prose P., Franklin E. C. Mixed cryoglobulinemia: clinical aspects and long-term follow-up of 40 patients. Am J Med. 1980 Aug;69(2):287–308. doi: 10.1016/0002-9343(80)90390-3. [DOI] [PubMed] [Google Scholar]
  8. Hawley P. R., Johnston A. W., Rankin J. T. Association between digital ischaemia and malignant disease. Br Med J. 1967 Jul 22;3(5559):208–212. doi: 10.1136/bmj.3.5559.208. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hild D. H., Myers T. J. Hyperviscosity in chronic granulocytic leukemia. Cancer. 1980 Sep 15;46(6):1418–1421. doi: 10.1002/1097-0142(19800915)46:6<1418::aid-cncr2820460622>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
  10. Hirai M. Cold sensitivity of the hand in arterial occlusive disease. Surgery. 1979 Feb;85(2):140–146. [PubMed] [Google Scholar]
  11. Johnson P. C., Rolak L. A., Hamilton R. H., Laguna J. F. Paraneoplastic vasculitis of nerve: a remote effect of cancer. Ann Neurol. 1979 May;5(5):437–444. doi: 10.1002/ana.410050505. [DOI] [PubMed] [Google Scholar]
  12. Miller S. P., Sanchez-Avalos J., Stefanski T., Zuckerman L. Coagulation disorders in cancer. I. Clinical and laboratory studies. Cancer. 1967 Sep;20(9):1452–1465. doi: 10.1002/1097-0142(196709)20:9<1452::aid-cncr2820200912>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  13. Moore P. M., Cupps T. R. Neurological complications of vasculitis. Ann Neurol. 1983 Aug;14(2):155–167. doi: 10.1002/ana.410140202. [DOI] [PubMed] [Google Scholar]
  14. NIELSEN B. L., PETRI C. [Peripheral symmetrical gangrene associated with metastasizing carcinoma of the colon]. Nord Med. 1963 Feb 21;69:237–239. [PubMed] [Google Scholar]
  15. O'Donnell J. R., Keaveny T. V., O'Connell L. G. Digital arteritis as a presenting feature of malignant disease. Ir J Med Sci. 1980 Oct;149(10):386–390. doi: 10.1007/BF02939176. [DOI] [PubMed] [Google Scholar]
  16. PERLOW S., DANIELS J. L. Venous thrombosis and obscure visceral carcinoma; report of ten cases. AMA Arch Intern Med. 1956 Feb;97(2):184–188. doi: 10.1001/archinte.1956.00250200060004. [DOI] [PubMed] [Google Scholar]
  17. Palmer H. M. Letter: Digital vascular disease and malignant disease. Br J Dermatol. 1974 Oct;91(4):476–477. doi: 10.1111/j.1365-2133.1974.tb13094.x. [DOI] [PubMed] [Google Scholar]
  18. Palmer H. M., Vedi K. K. Digital ischaemia and malignant disease. Practitioner. 1974 Dec;213(1278):819–822. [PubMed] [Google Scholar]
  19. Porter J. M., Rivers S. P., Anderson C. J., Baur G. M. Evaluation and management of patients with Raynaud's syndrome. Am J Surg. 1981 Aug;142(2):183–189. doi: 10.1016/0002-9610(81)90272-5. [DOI] [PubMed] [Google Scholar]
  20. Powell K. R. Raynaud's phenomenon preceding acute lymphocytic leukemia. J Pediatr. 1973 Mar;82(3):539–540. doi: 10.1016/s0022-3476(73)80143-x. [DOI] [PubMed] [Google Scholar]
  21. Rudolph R. I. Vasculitis associated with hairy cell leukemia. Arch Dermatol. 1980 Sep;116(9):1077–1078. [PubMed] [Google Scholar]
  22. Rösch J., Porter J. M., Gralino B. J. Cryodynamic hand angiography in the diagnosis and management of Raynaud's syndrome. Circulation. 1977 May;55(5):807–814. doi: 10.1161/01.cir.55.5.807. [DOI] [PubMed] [Google Scholar]
  23. Sack G. H., Jr, Levin J., Bell W. R. Trousseau's syndrome and other manifestations of chronic disseminated coagulopathy in patients with neoplasms: clinical, pathophysiologic, and therapeutic features. Medicine (Baltimore) 1977 Jan;56(1):1–37. [PubMed] [Google Scholar]
  24. Slichter S. J., Harker L. A. Hemostasis in malignancy. Ann N Y Acad Sci. 1974;230:252–261. doi: 10.1111/j.1749-6632.1974.tb14457.x. [DOI] [PubMed] [Google Scholar]
  25. Sun N. C., McAfee W. M., Hum G. J., Weiner J. M. Hemostatic abnormalities in malignancy, a prospective study of one hundred eight patients. Part I. Coagulation studies. Am J Clin Pathol. 1979 Jan;71(1):10–16. doi: 10.1093/ajcp/71.1.10. [DOI] [PubMed] [Google Scholar]
  26. Wytock D. H., Bartholomew L. G., Sheps S. G. Digital ischemia associated with small bowel malignancy. Gastroenterology. 1983 May;84(5 Pt 1):1025–1027. [PubMed] [Google Scholar]

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