Disseminated Intravascular Coagulation in a Patient With Metastatic Adenocarcinoma: A Case of Insidious Progression and Hematologic Complications

Disseminated intravascular coagulation (DIC) is a severe condition characterized by systemic activation of coagulation, resulting in the formation of microthrombi and consumption of clotting factors, leading to a paradoxical risk of both thrombosis and bleeding. Early diagnosis is crucial to initiating appropriate treatment before the condition worsens, as DIC is often associated with a poor prognosis once clinical signs appear. This case report presents a 60-year-old female patient with metastatic adenocarcinoma, initially diagnosed two years prior, who developed acute DIC shortly before her death. Despite an initial presentation of intractable back pain, nausea, and generalized weakness, laboratory findings demonstrated hemolytic anemia and abnormal coagulation, leading to the diagnosis of consumptive coagulopathy secondary to her advanced malignancy. The patient's declining condition was accompanied by worsening laboratory parameters, including elevated prothrombin time, international normalized ratio (INR), and fibrin degradation products, highlighting the insidious progression of DIC in cancer patients, particularly in the context of adenocarcinoma. Although treated with supportive care, including blood transfusions and withdrawal of anticoagulation, she ultimately succumbed to cardiopulmonary arrest. This case emphasizes the importance of early recognition of DIC in oncology patients, especially those with advanced-stage malignancies, as it often manifests in a less aggressive yet equally fatal form compared to DIC seen in conditions such as sepsis or trauma. Additionally, it emphasizes the need for vigilant laboratory monitoring in critically ill cancer patients to facilitate timely intervention.