Severe disseminated coagulopathy caused by adenocarcinoma with bone marrow metastasis

Onkologie. 2013;36(5):292-4. doi: 10.1159/000350327. Epub 2013 Apr 2.

Abstract

Background: Patients with mucin-producing adenocarcinoma have an increased risk for venous and arterial thrombosis. When these patients present with thrombocytopenia, disseminated intravascular coagulopathy (DIC) is often the underlying cause.

Case report: We report 2 patients who were admitted due to bleeding symptoms of unknown cause, in whom further workup revealed adenocarcinoma-induced DIC.

Conclusion: In elderly patients presenting with signs of DIC, such as reduced fibrinogen levels, elevated prothrombin time, elevated D-dimer, and thrombocytopenia, without any obvious reason (e.g., sepsis), adenocarcinoma-associated coagulopathy should be considered as the underlying cause. Paradoxically, in these patients bleeding symptoms improve when the patient is sufficiently anti-coagulated with low molecular weight heparin. Treatment of the underlying disease is of central importance in controlling acute or chronic DIC associated with malignant diseases and chemotherapy should be started as soon as possible.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / complications*
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / secondary*
  • Aged
  • Anticoagulants / therapeutic use
  • Bone Marrow Neoplasms / complications*
  • Bone Marrow Neoplasms / drug therapy
  • Bone Marrow Neoplasms / secondary*
  • Disseminated Intravascular Coagulation / drug therapy*
  • Disseminated Intravascular Coagulation / etiology*
  • Humans
  • Intestinal Neoplasms / complications*
  • Intestinal Neoplasms / drug therapy
  • Male
  • Treatment Outcome

Substances

  • Anticoagulants