A 50-Year-Old Man with Fulminant Alpha-Fetoprotein-Producing Gastric Carcinoma and Disseminated Intravascular Coagulation
Raffaele Longo, Philippe Carassou, Cassandre Leguay, Sarah Basin, Victoire Thiebaut, Elena-Adinisia Paraschiv, Ana-Maria Enea
Division of Medical Oncology, Metz Thionville Regional Hospital, Ars-Laquenexy, France
Am J Case Rep 2021; 22:e928369 :: DOI: 10.12659/AJCR.928369
Available online: 2021-01-25, In Press, Corrected Proof
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Alpha-fetoprotein-producing gastric carcinoma (AFPGC) is a rare but aggressive cancer with a poor prognosis. Disseminated intravascular coagulation (DIC) is usually associated with several tumors, including gastric cancer, but only a few cases have been reported in patients with AFPGC. This report describes a case of advanced-stage AFPGC associated with DIC in a 50-year-old White man.
CASE REPORT A 50-year-old, White, non-smoker man was hospitalized for a recent left hemiparesis associated with anorexia and loss of weigh. Clinically, we had multiple, hard, irregular, subcutaneous nodules, left supraclavicular lymph nodes, and a left, complete hemiparesis. Laboratory tests showed a DIC. A whole-body CT scan documented multiple lymph node, liver, subcutaneous, bone, and muscular metastases, a right femoral venous thrombosis, a left popliteal arterial thrombosis, and splenic and renal infarcts. The patient underwent an excisional biopsy of a subcutaneous lesion. Histology and immunohistochemistry confirmed the diagnosis of a metastasis from a high-grade AFPGC. Before starting any systemic treatment, the patient presented a massive intraventricular brain hemorrhage, quickly leading to his death.
CONCLUSIONS We report a case of metastatic AFPGC associated with a DIC and multiple venous and arterial thromboses resulting in a fatal intracerebral hemorrhage. AFPGC is a distinctive and very difficult to diagnose tumor showing aggressive behavior and poor prognosis.
Keywords: alpha-Fetoproteins; Antineoplastic Agents; Stomach Neoplasms