Fulminant digital necrosis in a patient with prostate adenocarcinoma

Paolini, María Virginia; Jankilevich, Gustavo; Graziano, Claudio; Romero, Diego S. Fernández

doi:10.1016/j.aller.2009.06.006

Cited by 6 publications

(5 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Second, thromboembolic mechanism by fragments of the tumor has also been described in histological analysis which showed fibrinoid necrosis of the vessels, intimal proliferation and heterogeneous inflammatory cell infiltrates or tissue necrosis with venous and/or arterial thrombosis. 35 , 36 Hypothesis of an immunologic mechanism is supported in literature by several arguments. First, arteritis may be related to tumor antigen-antibody complexes with subsequent complement activation in contact with the arterial wall.…”

Section: Discussionmentioning

confidence: 93%

Digital Ischemia Associated With Cancer

et al. 2014

View full text Add to dashboard Cite

Digital ischemia associated with cancer (DIAC) is increasing in frequency and recent reports have suggested the concept of paraneoplastic manifestation. The aims of this study were to characterize the clinical presentation of DIAC and identify clinical features that could lead physicians to diagnose underlying cancer.From January 2004 to December 2011, 100 patients were hospitalized in the Department of Internal Medicine at Rouen University Hospital, France for a first episode of DI. Fifteen (15%) exhibited symptomatic or asymptomatic cancer during the year preceding or following vascular episode and constituted the DIAC group. Other patients without cancer made up the digital ischemia (DI) group.Median time between diagnosis of cancer and episode of digital necrosis was 2 months [0.25–9]. Diagnosis of DI and concomitant cancer was made in 7 of the 15 patients, while DI preceded the malignant disorder in 2 cases and followed it in 6 cases. Histological types were adenocarcinoma for 7 (46.7%), squamous cell carcinoma for 4 (26.7%), and lymphoid neoplasia for 3 patients (20%). Six patients (40%) had extensive cancer. Three patients were lost to follow-up and 5 patients died <1 year after diagnosis of cancer. Cancer treatment improved vascular symptoms in 6 patients (40%). Patients with DIAC, compared to patients with DI, were significantly older (56 years [33–79] vs 46 [17–83] P =0.005), and had significantly lower hemoglobin and hematocrit levels (12.7 g/dl vs 13.9 g/dl; P =0.003 and 38% vs 42%; P =0.003, respectively). Patients with DIAC had a higher platelet rate (420 vs 300 G/L P =0.01), and 6 patients with DIAC (40%) had thrombocytosis. There was no difference between groups either in C-reactive protein level (12 mg/L vs 5 mg/L; P =0.08) or regarding cardiovascular risk factors, presence of autoimmunity, or monoclonal protein.This retrospective study suggests that DIAC may be more prevalent than previously reported. Outcomes of the 2 diseases were not strictly chronologically parallel. However, in the majority of cases, treatment of the tumor resolved vascular involvement. Our findings suggest that age >50 years and thrombocytosis should alert physicians to consider a possible occult malignancy when digital necrosis occurs.

show abstract

Section: Discussionmentioning

confidence: 93%

Digital Ischemia Associated With Cancer

et al. 2014

View full text Add to dashboard Cite

show abstract

“…However, the limited responses to these treatments observed in patients with underlying cancers, and the improvements seen with anticancer therapies, have led to the postulation of multiple mechanisms for peripheral vascular occlusion in this cohort. These include sympathetic hyperactivity as a result of tumour invasion; tumour antigen–antibody complex deposition with complement activation and vasculitis; immune dysregulation secondary to neoplasm; blood hyperviscosity due to excessive humoral factors such as cryoglobulins; hypercoagulability due to tumour activation of the haemostatic cascade, with resultant thrombosis; hypereosinophilia; intimal proliferation and thromboembolism of tumour fragments 1 14 15. Prompt diagnosis and treatment of the underlying cancer are, therefore, important in reducing morbidity from this paraneoplastic phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Digital ischaemia as a presenting feature in metastatic ovarian cancer

Miller,

Merry

2023

BMJ Case Rep

View full text Add to dashboard Cite

A woman in her 50s presented with acute pain and discolouration in the fingertips of both hands, without other features of connective tissue disease. The history was otherwise significant for abdominal bloating, altered bowel habit, urinary urgency and fatigue. Inflammatory markers, antinuclear antibodies, serum protein electrophoresis and complement levels were all normal. The tumour marker CA125 was significantly elevated, prompting a CT abdomen and pelvis, which revealed a large right-sided adnexal mass with multiple enhancing peritoneal and omental nodules and moderate ascites, suggestive of disseminated primary ovarian cancer.Digital ischaemia (DI) can be associated with cancer in up to 15% of cases. An underlying cancer should be suspected in patients presenting with new or worsening symptoms of DI. Prompt treatment with anticancer therapies can achieve complete resolution of DI.

show abstract

“…Arteritis is associated with digital artery vasospasm which leads to ischemia and gangrene in the lower extremities [6]. The cause of arteritis is still unknown, but it is suggested that tumor antigen-antibody complex deposition and complement activations in contact with the arterial wall induce vasculitis [7]. In some conditions, hypercoagulability and viscosity abnormalities may be seen with digital necrosis in patients with malignant tumors [8].…”

Section: Discussionmentioning

confidence: 99%

“…Paolini et al [7] reported fulminant digital necrosis in a patient with PCa. Our case was different from theirs in whom there was necrosis in the digits only.…”

Section: Discussionmentioning

confidence: 99%

Distal Phalangeal Necrosis in the Extremities as a Paraneoplastic Syndrome in Prostate Cancer: An Extremely Rare Case

Akın

Yücel²,

Baykara³

2013

Urol Int

View full text Add to dashboard Cite

Paraneoplastic syndromes (PNSs) are rare disorders which are triggered by an altered immune system response to a neoplasm. Although prostate cancer (PCa) is the second most common urological malignancy associated with PNSs, literature is lacking in defining the cases representing different PNSs in PCa. Herein, we present a 50-year-old man with fulminant distal phalangeal necrosis in the lower extremities after a diagnosis of PCa. Additionally, we review the literature in light of this case.

show abstract

Fulminant digital necrosis in a patient with prostate adenocarcinoma

Cited by 6 publications

References 7 publications

Digital Ischemia Associated With Cancer

Digital Ischemia Associated With Cancer

Digital ischaemia as a presenting feature in metastatic ovarian cancer

Distal Phalangeal Necrosis in the Extremities as a Paraneoplastic Syndrome in Prostate Cancer: An Extremely Rare Case

Contact Info

Product

Resources

About