Disseminated Intravascular Coagulation and Malignancy: A CaseReport and Literature Review

Disseminated Intravascular Coagulation (DIC) is a disorder of coagulation which is commonly seen as a complication of infections,traumas, obstetric diseases, and cancers especially hematological and rarely solid cancers. DIC may rarely be the presenting featureof an undiagnosed malignancy. It may present in the form of different phenotypes which makes its diagnosis difficult and leads tohigh mortality. The treatment comprises supportive, symptomatic treatment and removal of the underlying source. Here, wepresent a patient with history of being on warfarin for atrialfibrillation and other comorbidities who presented with elevatedINR of 6.3 and increasing dyspnea on exertion. Over the course of her stay, her platelet counts started dropping with aconcurrent decrease infibrinogen levels. She eventually developed pulmonary embolism, followed by stroke and limb ischemia,which was indicative of the thrombotic phenotype of DIC. Her pleuralfluid analysis showed huge burden of malignant cells inglandular pattern suggestive of adenocarcinoma and was started on heparin drip. However, the patient had cardiac arrest andexpired on the same day of diagnosis.