title: Successful initial treatment with weekly 24-hour infusion of 5-fluorouracil and leucovorin in a rectal cancer patient with acute disseminated intravascular coagulation.
abstract: Cancer-associated acute disseminated intravascular coagulation is rare in colorectal cancer, but is rapidly fatal when present. We present a case of a 79-year-old male who developed acute disseminated intravascular coagulation one month after receiving Hartmann's procedure for his rectal cancer. Peripheral blood showed leucoerythroblastosis while marrow carcinomatosis was noted by bone marrow examination. Prompt chemotherapy with weekly 24-h infusion of 5-fluorouracil and leucovorin were administered and the acute disseminated intravascular coagulation gradually resolved after 2 cycles of treatment. A total of 10 cycles of weekly chemotherapy were administered. The patient died of pneumonia on the 83rd day after diagnosis of disseminated intravascular coagulation without evidence of acute disseminated intravascular coagulation and tumor progression. We suggest that if acute disseminated intravascular coagulation developed after surgery for rectal cancer, the cancer-related acute disseminated intravascular coagulation should be taken into consideration. The immediate administration of chemotherapy may save the patient in time.
authors.affiliation: Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China.
authors.forename: Wen Tsung
authors.initials: WT
authors.lastname: Huang
authors.forename: Kung Chao
authors.initials: KC
authors.lastname: Chang
authors.forename: Yan Shen
authors.initials: YS
authors.lastname: Shan
authors.forename: Chao Jung
authors.initials: CJ
authors.lastname: Tsao
authors.forename: Jenq Chang
authors.initials: JC
authors.lastname: Lee
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000188:drug therapy* / Q000601:surgery; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D017809:Fatal Outcome; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage*; D008297:Male; D012004:Rectal Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000601:surgery; D013997:Time Factors
chemical_list: D000964:Antimetabolites, Antineoplastic; D002955:Leucovorin; D005472:Fluorouracil