title: Ventricular metastasis resulting in disseminated intravascular coagulation.
abstract: BACKGROUND: Disseminated Intravascular Coagulation (DIC) complicates up to 7% of malignancies, the commonest solid organ association being adenocarcinoma. Transitional Cell Carcinoma (TCC) has rarely been associated with DIC. CASE PRESENTATION: A 74-year-old woman with TCC bladder and DIC was found to have a cardiac lesion suspicious for metastatic disease. The DIC improved with infusion of plasma and administration of Vitamin K, however the cardiac lesion was deemed inoperable and chemotherapy inappropriate; given the patients functional status. We postulate that direct activation of the coagulation cascade by the intraventricular metastasis probably triggered the coagulopathy in this patient. CONCLUSION: Cardiac metastases should be considered in cancer patients with otherwise unexplained DIC. This may influence treatment choices.
authors.affiliation: Ludwig Institute Oncology Unit, Austin Health, Heidelberg, Victoria 3084, Australia. tom.john@ludwig.edu.au.
authors.forename: Thomas
authors.initials: T
authors.lastname: John
authors.forename: Ian D
authors.initials: ID
authors.lastname: Davis