We encountered a case of acute diffuse intravascular coagulation in a young women with progressive Stage IV NSCLC. There were no signs of infection of other complicating factors. Is it possible that the progessive tumour was the cause? We are aware of such situations in hematologic malignancies but unaware of it in solid tumours.
Malignancies include solid tumors could cause DIC and pulmonary embolism especially adenoCa.
Dear colleague.
Have seen a few cases with venous and also with arterial thrombosis during treatment with cisplatinum, either induction therapy or definitive treatment
Rick Pauljavascript:
VU med center
Of course venous and arterial thrombosis occur in a rather high frequency in malignancies. In this patient there were no sign of arterial or venous thrombosis and pulmonary embolism was ruled out by CT-angiogram. In this case there was a isolated and severe DIC.
As F. Fakill mentioned - DIC is not that uncommon in NSCLC and of course you have to consider paraneoplastic etiologies (more common in AC and SLC) due to the fact that you may have a mixed tumor.
Best Wolfgang
Dear: The situation usually in lung adenocarcinoma. Although it is rare in lung adenocarcinoma, but if occured, these patient has high tumor burden and usually poor prognosis and mortality in short time intervel
That was the case in this never smoking patient:, she had an extended adenocarcinoma (not yet treated with chemotherapy) and was rapidly progressive with fatal outcome within 2 days. We wonder whether immediate treatment with TKI ,s (there were indications for ALK mutation) would have changed the outcome.
Dear: usually these patients' lung adenoCa with negative EGFR mutation or ALK translocation. Therefore, immediate TKI donot work
yes,indeed but is of rare incidence.
About 12 years ago,a 70 yr. old patient developed a sudden haemodynamic fatal collapse due to PE previous evening of his proposed dismissal from hospital after an easy event free early convalescence following lobectomy for Bronchogenic CA.Thereafter all prophylactic measures including early ambulation,IPC and pharmacoprophylaxis are a routine following resection for NSCLC ,no matter what age group pt. belongs to.
Despite strict protocol including LMWH,a 45 yr. old patient died of massive PE 4 days after discharge upon readmission with massive PE although,he was administered thrombolytic therapy.So we believe PE is a real threat in Br.Ca following surgery in view of surgery,malignancy,release of thromboplastins,associatedl polycythemia to name a few.Fortunately with the way we have been doing ,we have not had PE ,touch wood ,in last 5 years in our unit performing 40to 50 resections yearly for NSCLC.
Dear colleague,
We are all familiar with frequent and different stage of severity of lung cancer complications and some times, dismal ones. The more efficacious and more targeted treatment options we have the more frequent complications we are going to deal with. As part of the paraneoplastic syndrome in NSLC, the occurrence of the DIC is not excluded, and the clinicians must be aware of this really dismal complication of the different cell types of lung cancer. I recommend a very interesting paper regarding the incidence and the management of such cases. I hope it will be useful.
"Disseminated intravascular coagulation (DIC) and non-small cell lung cancer (NSCLC): report of a case and review of the literature.E Voulgaris, G Pentheroudakis, A Vassou, N Pavlidis Lung cancer.01/2009; 64(2):247-9. DOI:10.1016/j.lungcan.2008.10.027"
Warmest regards
Dr. Sotiriou Ioannis
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