Department of Anesthesia and Perioperative Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan.
Division of Diagnostic Pathology, Ehime University Hospital, Toon, Ehime, Japan.
J Med Case Rep. 2021 Apr 10;15(1):155. doi: 10.1186/s13256-021-02773-x.
Malignant tumors, such as acute leukemia and solid cancers, frequently cause disseminated intravascular coagulation. However, cases of disseminated intravascular coagulation as a complication of bursitis were not reported previously.
A 72-year-old Japanese woman was scheduled to undergo resection of a rapidly growing subcutaneous tumor-like lesion on her left back. Preoperative blood tests suggested disseminated intravascular coagulation. The resected lesion was cystic tumor containing a hematoma. After the operation, the patient completely recovered from disseminated intravascular coagulation, indicating that disseminated intravascular coagulation in this case was caused by the tumor. Pathological examination of the resected tumor revealed considerable fibrin deposition and angiogenesis on the cyst wall, which was presumably a response to inflammation and indicated presence of repetitive intratumoral bleeding, subsequently leading to a diagnosis of chronic hemorrhagic bursitis.
Clinicians should note that, despite being benign, soft-tissue tumors accompanied by inflammation with angiogenesis and repetitive intratumoral bleeding can cause disseminated intravascular coagulation, albeit rarely.
恶性肿瘤，如急性白血病和实体癌，常引起弥漫性血管内凝血。然而，以前没有报道过滑囊炎作为并发症引起弥漫性血管内凝血的病例。
一名 72 岁的日本女性，计划接受左侧背部快速生长的皮下肿瘤样病变切除术。术前血液检查提示弥漫性血管内凝血。切除的病变为含有血肿的囊性肿瘤。手术后，患者的弥漫性血管内凝血完全恢复，表明本例弥漫性血管内凝血是由肿瘤引起的。切除肿瘤的病理检查显示囊壁有大量纤维蛋白沉积和血管生成，这可能是对炎症的反应，并表明存在反复的肿瘤内出血，随后诊断为慢性出血性滑囊炎。
临床医生应注意到，尽管是良性的，但伴有炎症、血管生成和反复肿瘤内出血的软组织肿瘤可引起弥漫性血管内凝血，尽管很少见。
