Kaohsiung Journal of Medical Sciences
Volume 24, Issue 6 , Pages 319-323, June 2008

Postoperative Disseminated Intravascular Coagulation in a Patient With Ureteral Metastasis from Gastric Cancer

  • Hsin-Chih Yeh

      Affiliations

    • Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Hsi-Lin Hsiao

      Affiliations

    • Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Tu-Hao Chang

      Affiliations

    • Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Sheng-Lan Wang

      Affiliations

    • Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Chun-Hsiung Huang

      Affiliations

    • Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Wen-Jeng Wu

      Affiliations

    • Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr Wen-Jeng Wu, Department of Urology, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan

Received 19 April 2007; accepted 20 August 2007.

A 66-year-old man, with a history of gastric signet ring cell carcinoma, was admitted due to intermittent dull pain in the left lower abdomen for 3 months. Left ureteral obstruction with suspicious tumor encasement and hydronephrosis was found on imaging studies. Endoscopic ureteral biopsy revealed infiltrating high-grade urothelial carcinoma. As a result, he underwent left nephroureterectomy and bladder cuff excision. Unexpectedly, metastatic carcinoma of the left ureter from the stomach was the final diagnosis after comparison of the permanent sections of the two specimens. Unfortunately, acute disseminated intravascular coagulation developed and the patient died of disease complications 16 days after the operation, even with intensive care. The details of this rare condition are reported herein with a review of the medical literature.

Key Words:  disseminated intravascular coagulation , gastric signet ring cell carcinoma , ureteral metastasis

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PII: S1607-551X(08)70159-1

doi:10.1016/S1607-551X(08)70159-1

Kaohsiung Journal of Medical Sciences
Volume 24, Issue 6 , Pages 319-323, June 2008

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