title: Disseminated intravascular coagulation complicating urothelial malignancy.
abstract: Transitional cell carcinoma has rarely been reported to be associated with disseminated intravascular  coagulation (DIC). We report a 55-year-old Chinese man who was diagnosed with transitional cell carcinoma with  vertebral metastasis. He presented with severe anaemia and thrombocytopenia, and subsequent evaluation revealed  features of DIC. Interestingly, he did not have fever, any localising symptoms or signs of infection. He was treated  aggressively with transfusion of packed cells, platelets, intravenous vitamin K and fresh frozen plasma. Despite aggressive  treatment, the coagulation abnormalities were resistant to correction. The patient continued to deteriorate and eventually  died of cardiac arrest. This case illustrates that transitional cell carcinoma can also be associated with DIC, possibly due  to the expression of certain unidentified procoagulant factors similar to the tissue factor responsible for DIC.
authors.affiliation: Department of General Medicine, Tan Tock Seng Hospital, Singapore. vmchadachan@gmail.com
authors.forename: Veerendra M
authors.initials: VM
authors.lastname: Chadachan
authors.forename: Siew Khow
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000740:Anemia / Q000209:etiology; D002295:Carcinoma, Transitional Cell / Q000097:blood / Q000150:complications*; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014516:Ureteral Neoplasms / Q000097:blood / Q000150:complications*