Abstract
A 32-year-old man admitted for abdominal pain and lumbago and diagnosed with sigmoid colon cancer with brain and multiple bone marrow metastases Reported anal bleeding, and laboratory data indicated acute disseminated intravascular coagulation (DIC). During anti-DIC therapy and blood transfusion, he suddenly developed peritonitis symptoms. An emergency Hartmann's procedure detected a perforated lesion and his condition became life-threatening as DIC deteriorated. Within 2 weeks of initiating an oxaliplatin/5-fluorouracil/leucovorin regimen (modified FOLFOX-6) on postoperative day6, clinical and laboratory evidence of acute DIC was resolved and his condition gradually improved after several cycles of this regimen. A partial response was also seen in brain and bone marrow metastases. Acute DIC due to such metastasis is extremely rare and generally considered fatal even with chemotherapy. Our case is unique in that modified FOLFOX-6 was effective in colon cancer accompanied by acute DIC.
