Issue: 2014 > May > review

Disseminated intravascular coagulation as clinical manifestation of colorectal cancer: a case report and review of the literature

C.C. van Bunderen, V.A. de Weger, A. Griffioen-Keijzer


We describe the case of a 65-year-old woman, known
with ulcerative colitis, who presented with progressive
headaches, haematomas and rectal bleeding which
turned out to be the initial manifestation of disseminated
intravascular coagulation (DIC) associated with colorectal cancer. The presentation posed as a general medicine case but turned out to be a rare oncological complication. The patient revealed possible carcinocythaemia and bone marrow infiltration with signet ring-like cells, as indicators of advanced adenocarcinoma. Treatment of the underlying disease resolved the DIC and contributed to prolonged
survival. Subsequently, we reviewed the English literature since 1990 on similar cases and demonstrated that this association is extremely rare and is associated with a poor prognosis. Prompt recognition and treatment of the underlying disease is confirmed to be of utmost
importance to prolong (progression-free) survival.