title: Effectiveness and safe use of modified FOLFOX-6 for metastatic gastric cancer with signet ring cell components complicated by disseminated intravascular coagulation and diffuse bone marrow carcinomatosis.
abstract: We report the case of a 62-year-old woman with a metastatic gastric cancer complicated by diffuse bone marrow carcinomatosis, disseminated intravascular coagulation (DIC) and microangiopathic hemolytic anemia (MHA) treated by modified FOLFOX-6 as front-line chemotherapy regimen. This chemotherapy showed clinical, morphological and biological efficiency and safety in this rare and severe hematological complication at initial diagnosis. Furthermore, this is the first case of diffuse bone carcinomatosis from a gastric cancer to be monitored by positron emission tomography integrated computed tomography (PET-CT) scan using 18-fluorodeoxyglucose (18-FDG).
authors.affiliation: Service d'oncologie, HIA Val de Grâce, Paris, France. francoisregisferrand@gmail.com
authors.forename: François-Régis
authors.initials: FR
authors.lastname: Ferrand
authors.forename: Eric
authors.initials: E
authors.lastname: Gontier
authors.forename: Sophie
authors.initials: S
authors.lastname: Guymar
authors.forename: Thierry
authors.initials: T
authors.lastname: Fagot
authors.forename: Bernard
authors.initials: B
authors.lastname: Ceccaldi
authors.forename: Jean-Valère
authors.initials: JV
authors.lastname: Malfuson
authors.forename: Thierry
authors.initials: T
authors.lastname: de Revel
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use* / Q000633:toxicity; D019046:Bone Marrow Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D002277:Carcinoma / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D018279:Carcinoma, Signet Ring Cell / Q000188:drug therapy* / Q000473:pathology; D003952:Diagnostic Imaging; D018450:Disease Progression; D004211:Disseminated Intravascular Coagulation / Q000150:complications*; D064420:Drug-Related Side Effects and Adverse Reactions; D017809:Fatal Outcome; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000633:toxicity; D005500:Follow-Up Studies; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000633:toxicity; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000633:toxicity; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil