晚期结肠癌膀胱转移继发弥散性血管内凝血一例

doi:10.16352/j.issn.1001-6325.2025.12.1648

基础医学与临床 ›› 2025, Vol. 45 ›› Issue (12): 1648-1652.doi: 10.16352/j.issn.1001-6325.2025.12.1648

晚期结肠癌膀胱转移继发弥散性血管内凝血一例

李思源¹, 东洁^2*

中国医学科学院北京协和医学院北京协和医院 1.血液科; 2.泌尿外科,北京 100730

收稿日期:2025-06-23 修回日期:2025-09-19 出版日期:2025-12-05 发布日期:2025-11-25
通讯作者: ^*pumchdongjie@163.com

Advanced colon cancer with bladder metastasis complicated by disseminated intravascular coagulation: a case report

LI Siyuan¹, DONG Jie^2*

1. Department of Hematology; 2. Department of Urology, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China

Received:2025-06-23 Revised:2025-09-19 Online:2025-12-05 Published:2025-11-25
Contact: ^*pumchdongjie@163.com

摘要/Abstract

摘要： 目的探讨晚期肿瘤继发弥散性血管内凝血的诊疗策略。方法回顾性采集了1例晚期结肠癌伴膀胱及盆壁多发转移的老年男性继发弥散性血管内凝血(DIC)的临床诊治资料,并对诊疗过程进行了分析与总结。结果患者在输血支持后成功实施手术解除梗阻,尽管后续序贯纠正凝血的支持治疗与抗凝治疗,但仍因肿瘤进展及DIC失代偿而预后不良。结论恶性肿瘤相关DIC的管理需动态评估凝血状态,即使在出血风险存在的情况下,适度抗凝可能有助于控制DIC。

关键词: 结肠癌, 膀胱转移, 弥散性血管内凝血

Abstract: Objective To investigate the management strategies for disseminated intravascular coagulation (DIC) secondary to advanced malignancies. Methods Clinical data of an elderly male with advanced colon cancer, multiple bladder/pelvic wall metastases, and secondary DIC was collected and analysed. Diagnostic and therapeutic processes were systematically evaluated. Results The patient successfully underwent surgery to relieve urinary tract obstruction after transfusion support. Despite subsequent correction of coagulopathy with supportive care and anticoagulation, the prognosis remained poor due to tumor progression and DIC decompensation. Conclusions The management of malignancy-complicated DIC requires dynamic assessment of coagulation status. Temperate anticoagulation might aid in DIC control even in the presence of bleeding risk.

Key words: colon cancer, bladder metastasis, disseminated intravascular coagulation

中图分类号:

李思源, 东洁. 晚期结肠癌膀胱转移继发弥散性血管内凝血一例[J]. 基础医学与临床, 2025, 45(12): 1648-1652.

LI Siyuan, DONG Jie. Advanced colon cancer with bladder metastasis complicated by disseminated intravascular coagulation: a case report[J]. Basic & Clinical Medicine, 2025, 45(12): 1648-1652.

参考文献

[1] Papageorgiou C, Jourdi G, Adjambri E, et al. Disseminated intravascular coagulation: an update on pathogenesis, diagnosis, and therapeutic strategies[J]. Clin Appl Thromb Hemost, 2018,24(9_suppl): 8S-28S. doi: 10.1177/1076029618806424.
[2] Levi M, Scully M. How I treat disseminated intravascular coagulation[J]. Blood, 2018,131:845-854. doi: 10.1182/blood-2017-10-804096.
[3] Khorana AA, Mackman N, Falanga A, et al. Cancer-associated venous thromboembolism[J]. Nat Rev Dis Primers, 2022,8:11. doi: 10.1038/s41572-022-00336-y.
[4] Seki Y, Okamoto K, Ikezoe T, et al. Clinical practice guidelines for management of disseminated intravascular coagulation in Japan 2024. Part 3: solid cancers and vascular abnormalities[J]. Int J Hematol, 2025,121:622-632. doi: 10.1007/s12185-024-03912-y.
[5] van Bunderen CC, de Weger VA, Griffioen-Keijzer A. Disseminated intravascular coagulation as clinical manifestation of colorectal cancer: a case report and review of the literature[J]. Neth J Med, 2014,72:186-189.
[6] Mizota A, Shitara K, Kondo C, et al. A case of heavily pretreated rectal cancer with disseminated intravascular coagulation that improved following reintroduction of FOLFOX plus bevacizumab[J]. Int J Clin Oncol, 2011,16:766-769. doi: 10.1007/s10147-011-0242-2.
[7] Kato H, Kohata K, Yamamoto J, et al. Extreme eosinophilia caused by interleukin-5-producing disseminated colon cancer[J]. Int J Hematol, 2010, 91:328-330. doi: 10.1007/s12185-010-0491-2.
[8] Misawa R, Kobayashi M, Ito M, et al. Primary colonic signet ring cell carcinoma presenting carcinocythemia: an autopsy case[J]. Case Rep Gastroenterol, 2008, 2:301-307. doi: 10.1159/000155146.
[9] Huang WT, Chang KC, Shan YS, et al. Successful initial treatment with weekly 24-hour infusion of 5-fluorouracil and leucovorin in a rectal cancer patient with acute disseminated intravascular coagulation[J]. Hepatogastroenterology, 2005,52:1436-1439.
[10] Yoshioka K, Shimizu H, Yokoo S, et al. Disseminated carcinomatosis of bone marrow from submucosal carcinoma in adenoma of the rectum[J]. Intern Med, 1992,31:1056-1059. doi: 10.2169/internalmedicine.31.1056.

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晚期结肠癌膀胱转移继发弥散性血管内凝血一例

Advanced colon cancer with bladder metastasis complicated by disseminated intravascular coagulation: a case report

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