Choriocarcinoma Presenting as Recurrent Intracranial Hemorrhage in an Adolescent Patient

Prado, Mario B.; Adiao, Karen Joy

doi:10.1016/j.jpag.2020.10.005

Cited by 1 publication

(2 citation statements)

References 7 publications

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“…28 It has also been reported that recurrent hemorrhagic stroke may be the initial manifestation of occult malignancy and may be related to DIC. 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

“…28 It has also been reported that recurrent hemorrhagic stroke may be the initial manifestation of occult malignancy and may be related to DIC. 29,30 The mechanism of paratumor DIC is not fully understood, but it is undoubtedly different from that of sepsisassociated DIC, where extensive endothelial damage is pathogenic. 31 In the early stages of cancer, coagulants, such as plasma cancer marker, inflammatory factors, and tissue factors, produced by the tumor 31,32 may cause an increase in platelets in the blood, lead to a hypercoagulable state, activate the coagulation system, produce excessive thrombin, and then increase the consumption of platelets, coagulation factors, and blood coagulation inhibitors, which puts the body in a state of DIC and increases the risk of intracranial hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Characteristics and Risk Factors of Cerebral Hemorrhage in Patients with Occult Malignant Tumors

Zhao¹,

Xie²,

Pan³

et al. 2021

NDT

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Propose To investigate the clinical characteristics and potential risk factors of the first onset of cerebral hemorrhage in patients with occult malignant tumors. Patients and methods In this retrospective study, 23 patients with occult malignant tumors with the first onset of cerebral hemorrhage were enrolled in the tumor group, and 92 patients without occult tumors in the same period were enrolled in the control group. There were no statistical differences in age and sex between both groups by propensity score matching. Collected clinical data included age, sex, smoking history, drinking history, hypertension history, diabetes history, past medical history, routine blood tests, neutrophil-to-lymphocyte ratio (NLR), liver and kidney function, fasting blood glucose level, coagulation function, tumor markers, imaging examinations, National Institute of Health stroke scale (NIHSS) score on admission, modified Rankin Scale (mRS) score 90 days after intracerebral hemorrhage and final mRS score. Results Compared with the control group, the tumor group had fewer patients with hypertension (52.2% vs 81.5%, P <0.05), and the NLR was significantly decreased in the tumor group (2.74 vs 5.46, P <0.05). The tumor group had a greater number of patients with the bleeding sites located in the lobar regions (43.5% vs.19.6%, P <0.05) and a higher coagulation dysfunction (52.2% vs 29.3%, P <0.05) than the control group. Multivariate logistic regression analysis revealed that no history of hypertension (OR: 3.141, 95% CI: 1.107–8.916), lobar cerebral hemorrhage (OR: 3.465 95% CI:1.172–10.243), and coagulation dysfunction (OR: 3.176, 95% CI: 1.131–8.913) were independent predictors of occult tumors, and the receiver operating characteristic (ROC) curve showed that the area under the curve of the three-index combined diagnosis was 0.748, C-statistic analysis also showed the same result. Conclusion No history of hypertension, lobar cerebral hemorrhage, and coagulation dysfunction may be predictors of the risk of occult malignancies in patients with cerebral hemorrhage.

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“…28 It has also been reported that recurrent hemorrhagic stroke may be the initial manifestation of occult malignancy and may be related to DIC. 29 , 30 …”

Section: Discussionmentioning

confidence: 99%