Cotton Wool Spots in Trousseau’s Syndrome

Trousseau’s syndrome is a paraneoplastic disorder characterized by a hypercoagulable state inducing either migratory superficial thrombophlebitis or arterial emboli from a nonbacterial thrombotic endocarditis. Cotton wool spots (CWS) are usually asymptomatic and represent small areas of retinal infarction. A 69 year-old man was investigated for multiple cerebral and cerebellar thromboembolic events and was found to harbour a metastatic pancreatic carcinoma.