Adrenal Crisis and Disseminated Intravascular Coagulation Associated With Disseminated Carcinomatosis of the Bone Marrow From Gastric Cancer

Abstract

Gastric cancer is the third leading cause of cancer deaths worldwide. Disseminated carcinomatosis of bone marrow (DCBM) originating from gastric cancer is rare and associated with poor prognosis. We present the first reported case of gastric adenocarcinoma with DCBM leading to concomitant disseminated intravascular coagulation (DIC) and adrenal crisis refractory to treatment. Computerized tomography of the chest, abdomen and pelvis showed diffuse sclerosis of the axial and proximal appendicular skeleton, suggestive of metastatic disease. Bone marrow biopsy demonstrated infiltrative signet ring cells, consistent with metastatic adenocarcinoma from gastric primary. Laboratory tests showed severe anemia, thrombocytopenia, and coagulopathy, compatible with DIC.