[Disseminated intravascular coagulation syndrome and thromboembolic complications of non-small-cell lung cancer. A case report].
Hemostatic disorders can be found in approximately 90% of cancer patients, but clinical expression in only 15%. Hemorrhagic complications are more frequent in acute leukaemia; solid tumors are often associated with deep venous thromboses (DVP). Disseminated intravascular coagulation syndrome (DICS) can be latent or acute, and has various clinical presentations, occurring in the course of many serious conditions including cancer. Patients have higher morbidity and mortality. Irrespective of the etiology, DICS can be revealed by a wide variety of clinical manifestations, from mild biological hemostasis disorders, to intravascular or extravascular microthromboses or lethal hemorrhagic events. We report the case of a 45-year-old female with non-small-cell lung cancer with metastases at diagnosis. The patient developed and finally died of numberous thromboembolic events subsequent to DICS. This case illustrates some rather rare complications of DICS and offers the opportunity to discuss the main therapeutic goal in this situation, i.e. to modulate the disproportionate production of thrombin, inducing thromboses and/or hemorrhages by consumption of the cellular and plasmatic coagulation factors. This means a symptomatic and mostly etiologic treatment, especially chemotherapy which can in itself provoke thromboembolic events.
Sakhri
L
L
Département de Pneumologie, Hôpital Lyautey, 1, rue des Canonniers, 67100 Strasbourg.
Jeung
M Y
MY
Forher
C
C
Pauli
G
G
Quoix
E
E
Mennecier
B
B
D000230:Adenocarcinoma / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality; D001780:Blood Coagulation Tests; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality; D004211:Disseminated Intravascular Coagulation / Q000150:complications* / Q000175:diagnosis; D004452:Echocardiography; D005260:Female; D006801:Humans; D020767:Intracranial Thrombosis / Q000209:etiology; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology; D011860:Radiography, Abdominal; D013902:Radiography, Thoracic; D012770:Shock, Cardiogenic / Q000209:etiology; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology; D013923:Thromboembolism / Q000209:etiology*; D014057:Tomography, X-Ray Computed