title: Conjunctival bleeding after ectropion repair due to paraneoplastic primary fibrinolysis.
abstract: In addition to predisposing a patient to hypercoaguability and thrombosis, cancers may also cause an antithetical bleeding diathesis through primary fibrinolysis. This paraneoplastic pathology has been documented and studied in prostate cancer patients for nearly a century but is under-recognized as a possible complication of surgery. We report a case of primary fibrinolysis after elective ectropion repair in a patient with prostate cancer. Here paraneoplastic fibrinolysis produced a delayed postoperative hemorrhage requiring specialized therapies, including hospitalization for transfusions of fresh frozen plasma and inhibitors of fibrinolysis. Even in the case of an ambulatory and stable cancer patient, awareness of this complication and its management can help guide surgical decision-making and improve outcomes and follow-up care.
authors: Cole Eye Institute, Cleveland, Ohio 44195, USA.
authors: Theodore A
authors: TA
authors: Pasquali
authors: Milap P
authors: MP
authors: Mehta
authors: Julian D
authors: JD
authors: Perry
mesh_terms: D000369:Aged, 80 and over; D000614:Aminocaproates / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003229:Conjunctival Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004483:Ectropion / Q000601:surgery*; D017707:Erythrocyte Transfusion; D005143:Eyelids / Q000601:surgery; D005169:Factor VIII / Q000627:therapeutic use; D005340:Fibrinogen / Q000627:therapeutic use; D005342:Fibrinolysis; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D059545:Paraneoplastic Syndromes, Ocular / Q000150:complications* / Q000628:therapy; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018714:Radiotherapy, Adjuvant
chemical_list: D000614:Aminocaproates; D005343:Fibrinolytic Agents; C026912:cryoprecipitate coagulum; D005169:Factor VIII; D005340:Fibrinogen