Disseminated intravascular coagulation: complication of advanced urologic malignancy, case report.

Abstract

Disseminated intravascular coagulation (DIC) is an acquired and complex syndrome that may present in acute or compensated forms across various clinical scenarios. This report presents the case of a 79-year-old male who presented with hematuria, dyspnea, and dizziness, along with findings of coagulopathy refractory to vitamin K, with transient improvement following fresh frozen plasma transfusion. Computed tomography and magnetic resonance imaging revealed a locally advanced bladder neoplasm with prostatic, lymphatic, and osseous dissemination. Due to clinical suspicion of DIC, a coagulation panel was requested, showing prolonged INR, decreased factor VII and IX levels, and elevated D-dimer and fibrinogen, findings consistent with compensated DIC. This case highlights the importance of recognizing DIC as a paraneoplastic manifestation and the need for both hemostatic stabilization and treatment of the underlying cause.