Effectiveness and safe use of modified FOLFOX-6 for metastatic gastric cancer with signet ring cell components complicated by disseminated intravascular coagulation and diffuse bone marrow carcinomatosis

Onkologie. 2012;35(3):118-20. doi: 10.1159/000336971. Epub 2012 Feb 20.

Abstract

We report the case of a 62-year-old woman with a metastatic gastric cancer complicated by diffuse bone marrow carcinomatosis, disseminated intravascular coagulation (DIC) and microangiopathic hemolytic anemia (MHA) treated by modified FOLFOX-6 as front-line chemotherapy regimen. This chemotherapy showed clinical, morphological and biological efficiency and safety in this rare and severe hematological complication at initial diagnosis. Furthermore, this is the first case of diffuse bone carcinomatosis from a gastric cancer to be monitored by positron emission tomography integrated computed tomography (PET-CT) scan using 18-fluorodeoxyglucose (18-FDG).

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / toxicity
  • Bone Marrow Neoplasms / complications*
  • Bone Marrow Neoplasms / drug therapy*
  • Bone Marrow Neoplasms / pathology
  • Carcinoma / complications*
  • Carcinoma / drug therapy*
  • Carcinoma / pathology
  • Carcinoma, Signet Ring Cell / drug therapy*
  • Carcinoma, Signet Ring Cell / pathology
  • Diagnostic Imaging
  • Disease Progression
  • Disseminated Intravascular Coagulation / complications*
  • Drug-Related Side Effects and Adverse Reactions
  • Fatal Outcome
  • Female
  • Fluorouracil / administration & dosage
  • Fluorouracil / toxicity
  • Follow-Up Studies
  • Humans
  • Leucovorin / administration & dosage
  • Leucovorin / toxicity
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Staging
  • Organoplatinum Compounds / administration & dosage
  • Organoplatinum Compounds / toxicity
  • Purpura, Thrombotic Thrombocytopenic / complications
  • Purpura, Thrombotic Thrombocytopenic / drug therapy
  • Purpura, Thrombotic Thrombocytopenic / pathology
  • Sensitivity and Specificity
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / pathology
  • Treatment Outcome

Substances

  • Organoplatinum Compounds
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol