J Gastric Cancer.  2013 Jun;13(2):121-125.

Advanced Gastric Cancer Associated with Disseminated Intravascular Coagulation Successfully Treated with 5-fluorouracil and Oxaliplatin

Affiliations
  • 1Department of Internal Medicine, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, Korea. anijune@gnah.co.kr
  • 2Department of Pathology, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, Korea.

Abstract

Gastric cancer patients with acute disseminated intravascular coagulation experiences a rare but severe complication resulting in a dismal prognosis. We report a case of advanced gastric cancer complicated with disseminated intravascular coagulation with intractable tumor bleeding which was successfully treated with chemotherapy consisting of 5-fluorouracil and oxaliplatin. The patient was a 63-year-old man who complained of abdominal pain, melena, and dyspnea on 24 November 2010. We diagnosed stage IV gastric cancer complicated by disseminated intravascular coagulation. Gastric tumor bleeding was not controlled after procedures were repeated three times using gastrofiberscopy. With the patient's consent, we selected the 5-fluorouracil and oxaliplatin combination chemotherapy for treatment. After one cycle of 5-fluorouracil and oxaliplatin therapy, symptoms of bleeding improved and the disseminated intravascular coagulation process was successfully controlled. The primary tumor and multiple metastatic bone lesions were remarkably shrunken and metabolically remitted after eight cycles of chemotherapy. In spite of progression, systemic chemotherapy is effective in disease control; further, the patient gained the longest survival time among cases of gastric cancer with disseminated intravascular coagulation.

Keyword

Stomach neoplasms; Disseminated intravascular coagulation; Fluorouracil; Oxaliplatin

MeSH Terms

Abdominal Pain
Disseminated Intravascular Coagulation
Drug Therapy, Combination
Dyspnea
Fluorouracil
Hemorrhage
Humans
Melena
Organoplatinum Compounds
Prognosis
Stomach Neoplasms
Fluorouracil
Organoplatinum Compounds
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