Postoperative disseminated intravascular coagulation in a patient with ureteral metastasis from gastric cancer.
A 66-year-old man, with a history of gastric signet ring cell carcinoma, was admitted due to intermittent dull pain in the left lower abdomen for 3 months. Left ureteral obstruction with suspicious tumor encasement and hydronephrosis was found on imaging studies. Endoscopic ureteral biopsy revealed infiltrating high-grade urothelial carcinoma. As a result, he underwent left nephroureterectomy and bladder cuff excision. Unexpectedly, metastatic carcinoma of the left ureter from the stomach was the final diagnosis after comparison of the permanent sections of the two specimens. Unfortunately, acute disseminated intravascular coagulation developed and the patient died of disease complications 16 days after the operation, even with intensive care. The details of this rare condition are reported herein with a review of the medical literature.
Yeh
Hsin-Chih
HC
Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Hsiao
Hsi-Lin
HL
Chang
Tu-Hao
TH
Wang
Sheng-Lan
SL
Huang
Chun-Hsiung
CH
Wu
Wen-Jeng
WJ
D000368:Aged; D001706:Biopsy; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary*; D002454:Cell Differentiation; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000175:diagnosis*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D011184:Postoperative Period; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D016896:Treatment Outcome; D014513:Ureter / Q000473:pathology; D014571:Urologic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary*; D019459:Urothelium / Q000473:pathology*