Disseminated intravascular coagulation after cryoablation for metastatic pancreatic cancer: a case report

被引:0
作者
Dulu, Alina [1 ]
Tayban, Yekaterina [1 ]
Delaleu, Joanne [1 ]
Cornelis, Francois H. [2 ]
Pastores, Stephen M. [1 ,3 ,4 ]
机构
[1] Mem Sloan Kettering Canc Ctr, Crit Care Ctr, Dept Anesthesiol & Crit Care Med, New York, NY USA
[2] Mem Sloan Kettering Canc Ctr, Intervent Radiol Serv, New York, NY 10065 USA
[3] Mem Sloan Kettering Canc Ctr, Dept Anesthesiol & Crit Care Med, Crit Care Med, 1275 York Ave C-1179, New York, NY 10065 USA
[4] Mem Sloan Kettering Canc Ctr, Dept Anesthesiol & Crit Care Med, Educ, 1275 York Ave C-1179, New York, NY 10065 USA
来源
AME MEDICAL JOURNAL | 2023年 / 8卷
关键词
Cryoablation; pancreatic cancer (PC); bone metastasis; disseminated intravascular coagulation (DIC); case report; CRYOSURGERY; 5-YEAR;
D O I
10.21037/amj-23-13
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Pancreatic cancer is the fourth most common cause of cancer-related death in the United States. Despite advancements in surgery and chemoradiation therapies, pancreatic cancer has a 5-year survival rate of only 11% in the United States. Cryoablation is emerging as a new and effective therapy for locally advanced pancreatic cancer and symptom palliation in metastatic disease. To our knowledge, the occurrence of disseminated intravascular coagulation (DIC) after cryoablation is rare. Case Description: A 47-year-old woman with no significant past medical history was diagnosed with pancreatic cancer and underwent a Whipple procedure followed by chemotherapy with gemcitabine and paclitaxel. Due to the abdominal lymph nodes, peritoneum, right femur, and surrounding soft tissue metastases, she received systemic palliative chemotherapy with gemcitabine and paclitaxel and underwent right femur tumor excision, open reduction, and internal fixation, followed by radiation therapy. She continued to have persistent pain and underwent palliative percutaneous cryoablation of the metastatic tumor under computed tomography (CT) and ultrasound guidance. Immediately post procedure, she developed slow but continuous blood oozing at the ablation site, which was difficult to control despite compression dressings, reinforcement sutures, and local thrombin powder. The patient was transferred to the intensive care unit where she was noted to be hypotensive and tachycardic, with petechiae in both lower extremities. Laboratory studies were consistent with DIC and peripheral blood smear revealed multiple schistocytes. CT angiogram of the right lower extremity did not show any bleeding vessel amenable to embolization. She was transfused red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. Despite multiple daily transfusions, she continued to have pain and remained persistently thrombocytopenic and coagulopathic. After discussion with the patient and her family, she chose to transition to comfort care measures and died. Conclusions: DIC is an unusual but life-threatening complication of advanced pancreatic cancer.
引用
收藏
页数:6
相关论文
共 50 条
  • [31] Case report of nab-paclitaxel in metastatic pancreatic cancer
    Haslbauer F.
    memo - Magazine of European Medical Oncology, 2014, 7 (1) : 39 - 42
  • [32] A case report of cryoablation and electrochemotherapy in kidney cancer
    Mastrandrea, Giovanni
    Laface, Carmelo
    Fazio, Vito
    Lopetuso, Marco
    Falagario, Gianmarco
    Molinari, Pasquale
    Ranieri, Girolamo
    Gadaleta, Cosmo Damiano
    MEDICINE, 2021, 100 (45) : E27730
  • [33] Case report: PD-1 inhibitor-based treatment strategies in gastric cancer complicated by bone marrow metastasis and disseminated intravascular coagulation: A report of two cases
    Huang, Ren-Ze
    Chen, Nuo
    Hu, Yan
    Hu, Wan-Ming
    Wang, Feng-Hua
    Chen, Dong-Liang
    FRONTIERS IN ONCOLOGY, 2023, 13
  • [34] Disseminated Intravascular Coagulation With Excessive Fibrinolysis Following Diagnostic Prostatic Biopsy for Prostate Cancer
    Ghallab, Muhammad
    Ilyas, Usman
    Tran, Lilian
    Amin, Toka
    Abdelmoteleb, Salma
    CUREUS JOURNAL OF MEDICAL SCIENCE, 2022, 14 (10)
  • [35] Successful surgical management of non-perforating acute appendicitis with septic disseminated intravascular coagulation: A case report and review of the literature
    Komo, Toshiaki
    Kohashi, Toshihiko
    Aoki, Yoshirou
    Hihara, Jun
    Oishi, Koichi
    Tokumoto, Noriaki
    Kanou, Mikihiro
    Nakashima, Akira
    Shimomura, Manabu
    Miguchi, Masashi
    Mukaida, Hidenori
    Hirabayashi, Naoki
    INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS, 2019, 55 : 103 - 106
  • [36] Preoperative disseminated intravascular coagulation complicated by thoracic aortic aneurysm treated using recombinant human soluble thrombomodulin A case report
    Tanigawa, Yoshinori
    Yamada, Yasutaka
    Nakamura, Kimihide
    Yamashita, Tomoko
    Nakagawachi, Akira
    Sakaguchi, Yoshiro
    MEDICINE, 2021, 100 (09) : E25044
  • [37] A rare case report of recurrent metastatic breast cancer mimicking primary pancreatic cancer
    Prakash, Prajwala S.
    Lee, James Wai Kit
    Tang, Siau Wei
    Iau, Philip Tsau Choong
    INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS, 2020, 77 : 446 - 449
  • [38] A Fatal Case of Intravascular Coagulation After Bee Sting Acupuncture
    Jung, Jae Woo
    Jeon, Eun Ju
    Kim, Jeong Wook
    Choi, Jae Chol
    Shin, Jong Wook
    Kim, Jae Yeol
    Park, In Won
    Choi, Byoung Whui
    ALLERGY ASTHMA & IMMUNOLOGY RESEARCH, 2012, 4 (02) : 107 - 109
  • [39] Recalcitrant postoperative bleeding after ectropion repair in the setting of undiagnosed chronic disseminated intravascular coagulation
    Rosenblatt, Tatiana R.
    Lin, Lisa Y.
    Chiou, Carolina A.
    Lee, Nahyoung Grace
    Gulati, Gunsagar S.
    Bendapudi, Pavan K.
    Wolkow, Natalie
    ORBIT-THE INTERNATIONAL JOURNAL ON ORBITAL DISORDERS-OCULOPLASTIC AND LACRIMAL SURGERY, 2025, 44 (02): : 196 - 199
  • [40] Successful conservative treatment for massive uterine bleeding with non-septic disseminated intravascular coagulation after termination of early pregnancy in a woman with huge adenomyosis: case report
    Fuminori Kimura
    Akimasa Takahashi
    Jun Kitazawa
    Fumi Yoshino
    Daisuke Katsura
    Tsukuru Amano
    Takashi Murakami
    BMC Women's Health, 20