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18 January 2020 : Case report  Iran

A Case of Antiphospholipid Syndrome Following Gastric Signet Ring Cell Adenocarcinoma

Rare disease

Mohammad Shayestehpour12BEF, Majid Ehsani1AC, Davood Dadkhah1B, Batool Zamani1AC*

DOI: 10.12659/AJCR.919037

Am J Case Rep 2020; 21:e919037

Abstract

BACKGROUND: Antiphospholipid syndrome (APS) is a rare autoimmune disease characterized by arterial, venous, and small-vessel thrombosis, pregnancy-related morbidity and the presence of antiphospholipid antibodies such as anticardiolipin antibody, and/or anti-beta2-glycoprotein I. In the recent years, APS was observed in patients with solid tumors and the renal cancer, lung carcinoma and breast tumors were the most common tumors linked with APS.

CASE REPORT: A 53-year-old female presented with pain and pitting edema of left lower extremity that had begun 6 months prior to hospitalization. Deep vein thrombosis (DVT) in the popliteal vein diagnosed by Doppler ultrasonography and the patient was treated with heparin followed by warfarin. Following subdural hematoma, anticoagulant therapy was stopped, and the patient underwent craniotomy. One month later, the patient returned with pain and DVT diagnosed in its right leg. Laboratory tests showed high levels of lupus anticoagulant, IgM and IgG anticardiolipin antibodies. Following a high alkaline phosphatase, diffuse bone marrow involvement was found by whole body bone scan. Looking to find primary tumor, a large infilterable lesion in gastric was seen by endoscopic images, and biopsy histopathology showed a signet ring cell adenocarcinoma. The patient refused chemotherapy and died 6 months after diagnosis.

CONCLUSIONS: APS is associated with gastric signet ring cell adenocarcinoma.

Keywords: Antibodies, Anticardiolipin, Antiphospholipid Syndrome, Stomach Neoplasms, Carcinoma, Signet Ring Cell, Fatal Outcome, Middle Aged

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923