SPONTANEOUS INTERNAL JUGULAR-VEIN THROMBOSIS AND RECURRENT LARYNGEAL NERVE PALSY - A RARE SIMULTANEOUS PRESENTATION OF AN OCCULT MALIGNANT NEOPLASM

Internal jugular vein thrombosis is an uncommon potentially life-threa tening disorder caused by various conditions. Non-spontaneous internal jugular vein thrombosis is an uncommon condition associated in the pr e-antibiotic area with deep-neck infections. Currently iatrogenic trau ma to the internal jugular vein from catheterisation and repeated intr avenous injections by drug abusers are the leading causes of thrombosi s. Spontaneous internal jugular vein thrombosis may occur when there a re no apparent pre-disposing mechanical or inflammatory causes althoug h a few of these patients may harbour an occult malignant neoplasm. He nce, careful investigation and follow-up are vital. Thrombosis in Trou sseau's syndrome is usually confined to the vascular system of the ext remities and the viscera. However, secondary to the paraneoplastic hyp ercoagulable state, thrombosis can occur in the large veins of the hea d and neck region. We understand this to be the first case where spont aneous internal jugular vein thrombosis and ipsilateral recurrent lary ngeal nerve paralysis were the only initial manifestations of an occul t malignancy.