Asymptomatic Severe Acquired von Willebrand’s Syndrome in Association With a Glioblastoma Multiforme: A Case Report

Abstract

To our knowledge, this is the first reported case of a severe acquired von Willebrand's Syndrome (avWS) in association with a Glioblastoma Multiforme (GBM). We report a case of a 70-year-old male who presented to the hospital with neurologic findings secondary to a thalamic mass and subsequent hydrocephalus but without any prior history of any bleeding diathesis. A biopsy and septum pellucidotomy was considered and coagulation parameters from pre-operative chemistry returned deranged. Further investigations for bleeding disorders have been performed and an avWS was diagnosed due to the low levels of factor VIII, vWF:Ag, and vWF:RiCoF. The patient responded to a single dose of IVIG and hence the contemplated procedure has been performed. Subsequently, a histopathologic diagnosis of a GBM was made and unfortunately no further treatment was pursued due to the patient's poor response to the initial surgical intervention.

Severe haemorrhagic diathesis due to acquired hypofibrinogenemia in a patient with early T-cell precursor acute lymphoblastic leukaemia/lymphoma: a case report

“…Thirdly, we performed a full panel of tests that allowed us to exclude other possible causes of acquired hypofibrinogenemia such as the presence of liver diseases; moreover, we also excluded drug-induced hypofibrinogenemia at the time of admission. Interestingly, a case report by Inano S. et al ( 20 ) detected acquired hypofibrinogenemia in a patient with multiple myeloma with a mechanism similar to that postulated in our patient which the authors have coined “leukocyte-mediated fibrinogen removal.” A few other studies have also proposed a mechanism of sequestration by neoplastic cells to explain bleeding diathesis due to acquired von Willebrand syndrome both in patients with solid tumours ( 24 , 25 ) and in children with Wilms tumour ( 26 – 28 ). It bears noting that the results of functional tests for fibrinogen assessment may have been influenced by elevated D-dimer levels.…”