title: [Favorable prognosis in a case of recurrent cerebral infarctions caused by chronic disseminated intravascular coagulation due to ovarian carcinoma].
abstract: We report a 53-year-old woman who developed a cerebral infarction in the left middle cerebral artery area. Although she did not have a hemorrhagic tendency, the results of her examination showed a chronic disseminated intravascular coagulation (DIC) and a left ovarian carcinoma. Gabexate mesilate (FOY) and nafamostat mesilate (FUT) were not effective for her DIC. One month after admission, she had another cerebral infarction in the right posterior cerebral artery area. She was treated by heparin sodium and her chronic DIC improved. Then, she was operated on for ovarian carcinoma; the histologic finding was clear cell adenocarcinoma. No recurrence of DIC nor cerebral infarction was observed postoperatively. Patients with cerebral infarctions caused by chronic DIC due to ovarian carcinoma have been reported in the literature, but few patients had a favorable prognosis such as the present case. Heparin therapy appears to be the treatment of choice for chronic DIC rather than FOY or FUT, if there is no hemorrhagic tendency. When a patient with DIC develops cerebral infarction, one should always investigate for possible malignant tumors.
authors.affiliation: Fourth Department of Internal Medicine, Aichi Medical University, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Izumi
authors.forename: S
authors.initials: S
authors.lastname: Terao
authors.forename: J
authors.initials: J
authors.lastname: Takagi
authors.forename: J
authors.initials: J
authors.lastname: Koshimura
authors.forename: S
authors.initials: S
authors.lastname: Takatsu
authors.forename: T
authors.initials: T
authors.lastname: Mitsuma
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000150:complications*; D002544:Cerebral Infarction / Q000209:etiology*; D002908:Chronic Disease; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications*; D011379:Prognosis; D012008:Recurrence