Abstract
Disseminated intravascular coagulation syndrome (DIC) is an acquired disorder in which intravascular coagulation may lead to microvascular fibrin formation and a hemorrhagic diathesis. Since there are various underlying diseases, the balance of the coagulation system and fibrinolysis system differs case by case. DIC is often encountered as disseminated hemorrhage in the field of oral surgery. When the underlying disease is clear, the diagnosis is comparatively easy, but otherwise the diagnosis may be difficult. We report a case of DIC with advanced fibrinolysis caused by prostatic cancer presenting as a gingival hemorrhage. The patient was referred to our department complaining of prolonged hemorrhage from the gingiva. The clinical examination of bleeding tendency (platelet number, prothrombin time, fibrinogen level, bleeding time) did not show remarkable abnormal values. An additional examination of FDP and D-dimer yielded a diagnosis of DIC, and it became clear that prostatic cancer was the underlying disease of DIC. Therefore, hormone therapy was carried out, and the hemorrhage arrested quickly and spontaneously. When treating unexplained hemorrhage, it is important to conduct an appropriate screening examination and to consider a differential diagnosis of DIC.
