Primary "spontaneous" upper extremity deep vein thrombosis is uncommon and is defined as thrombosis of the deep veins draining the upper extremity due to anatomic abnormalities of the thoracic outlet causing axillosubclavian compression and next thrombosis. The syndrome is accurately termed venous thoracic outlet syndrome but is likewise called Paget-Schroetter syndrome, and rather as "effort" thrombosis.¹ An aggressive treatment technique that consists of anticoagulation, catheter-directed thrombolysis or thoracic outlet decompression is done towards relieving acute signs and symptoms and minimizing complications, like recurrent thromboembolism and post-thrombotic syndrome. Here we report a 45 old female, a coolie by profession, came with complaints of left arm swelling and pain for one month duration. On evaluation, patient found to have substantial thrombosis of subclavian, axillary and basilic veins, without any other cause and diagnosed to be  primary spontaneous in nature. Patient was then managed with anticoagulants and discharged with the advice of regular follow up.

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Dr B. Nandini Priyanka

Post Graduate, Department of Medicine,

RMMCH, Chidambaram-608002,Tamilnadu