Katayama Kazuhisa, Okitsu Hiroshi, Kimura Suguru, Hara Tomoko, Ozaki Keiji, Goto Tetsuya, Yamashita Michiko, Fujii Yoshiyuki
Dept. of Surgery, Tokushima Red Cross Hospital.
Gan To Kagaku Ryoho. 2008 Jul;35(7):1201-4.
Bone marrow carcinosis due to gastric cancer with disseminated intravascular coagulation(DIC)occurs suddenly, progresses rapidly, and has a very poor prognosis. In addition, physical status tends to be bad at the time of the episode, and palliative care is generally selected as the treatment method. The case was a 70-year-old woman who underwent total gastrectomy for scirrhous stomach cancer five years previously. She recently noticed gingival hemorrhage, and was referred to our hospital by a nearby doctor. As a result of her examination, she was diagnosed with disseminated bone marrow carcinosis as a postoperative recurrence of gastric cancer that resulted in DIC. We transfused blood platelets and fresh frozen plasma into her, and controlled the bleeding tendency temporarily. She was started on oral administration of S-1 for improvement of DIC, and the therapy was successful without loss of QOL. It is easy to continue S-1 therapy as chemotherapy in the outpatient department, because it is a matter of internal medicine.
胃癌伴弥散性血管内凝血(DIC)导致的骨髓转移癌发病突然、进展迅速且预后极差。此外,发病时身体状况往往较差,一般选择姑息治疗。该病例为一名70岁女性,五年前因硬癌性胃癌接受了全胃切除术。她最近发现牙龈出血,由附近医生转诊至我院。检查结果显示,她被诊断为胃癌术后复发导致DIC的弥散性骨髓转移癌。我们为她输注了血小板和新鲜冷冻血浆,暂时控制了出血倾向。她开始口服S-1以改善DIC,治疗成功且未影响生活质量。由于S-1治疗属于内科范畴,在门诊作为化疗持续进行很容易。