title: Disseminated gastric carcinoma in disguise-presentation as microangiopathic haemolytic anemia with bone marrow necrosis.
abstract: Cancer related microangiopathic hemolytic anemia (MAHA) and bone marrow necrosis (BMN) are two rare and distinct clinicopathological entities reported in patients with disseminated malignancy. When they emerge as initial findings in a previously undetected case of malignancy, the diagnosis is often missed resulting in inappropriate management. We report the extremely rare association of cancer related MAHA and BMN as the first presentation of unsuspected disseminated gastric carcinoma in a 63 years old male. Early institution of chemotherapy is the only effective option for both these conditions, though with little improvement in outcome. This emphasises the need for increased awareness of such presentations in advanced malignancies.
authors.affiliation: Malabar Institute of Medical Sciences Ltd., Calicut, Kerala, India.
authors.forename: Jyotsna
authors.initials: J
authors.lastname: Yesodharan
authors.affiliation: Malabar Institute of Medical Sciences Ltd., Calicut, Kerala, India.
authors.forename: Shalini
authors.initials: S
authors.lastname: Kuruvilla
authors.affiliation: Malabar Institute of Medical Sciences Ltd., Calicut, Kerala, India.
authors.forename: Kanjirakkad
authors.initials: K
authors.lastname: Parameswaran Kavitha
authors.affiliation: Malabar Institute of Medical Sciences Ltd., Calicut, Kerala, India.
authors.forename: Madhavan
authors.initials: M
authors.lastname: Lilly
keywords: Gastric carcinoma; bone marrow necrosis (BMN); microangiopathic hemolytic anemia (MAHA)