title: Advanced Gastric Cancer Associated with Disseminated Intravascular Coagulation Successfully Treated with 5-fluorouracil and Oxaliplatin.
abstract: Gastric cancer patients with acute disseminated intravascular coagulation experiences a rare but severe complication resulting in a dismal prognosis. We report a case of advanced gastric cancer complicated with disseminated intravascular coagulation with intractable tumor bleeding which was successfully treated with chemotherapy consisting of 5-fluorouracil and oxaliplatin. The patient was a 63-year-old man who complained of abdominal pain, melena, and dyspnea on 24 November 2010. We diagnosed stage IV gastric cancer complicated by disseminated intravascular coagulation. Gastric tumor bleeding was not controlled after procedures were repeated three times using gastrofiberscopy. With the patient's consent, we selected the 5-fluorouracil and oxaliplatin combination chemotherapy for treatment. After one cycle of 5-fluorouracil and oxaliplatin therapy, symptoms of bleeding improved and the disseminated intravascular coagulation process was successfully controlled. The primary tumor and multiple metastatic bone lesions were remarkably shrunken and metabolically remitted after eight cycles of chemotherapy. In spite of progression, systemic chemotherapy is effective in disease control; further, the patient gained the longest survival time among cases of gastric cancer with disseminated intravascular coagulation.
authors.affiliation: Department of Internal Medicine, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, Korea.
authors.forename: Dong Seok
authors.initials: DS
authors.lastname: Lee
authors.forename: Seung Jin
authors.initials: SJ
authors.lastname: Yoo
authors.forename: Ho Suk
authors.initials: HS
authors.lastname: Oh
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Kim
authors.forename: Kwang Hoon
authors.initials: KH
authors.lastname: Oh
authors.forename: Sang Jin
authors.initials: SJ
authors.lastname: Lee
authors.forename: Jong Kyu
authors.initials: JK
authors.lastname: Park
authors.forename: Yong Chel
authors.initials: YC
authors.lastname: Ahn
authors.forename: Dae-Woon
authors.initials: DW
authors.lastname: Eom
authors.forename: Heui June
authors.initials: HJ
authors.lastname: Ahn
keywords: Disseminated intravascular coagulation; Fluorouracil; Oxaliplatin; Stomach neoplasms