A CASE OF EARLY GASTRIC CANCER ASSOCIATED WITH CONGENITAL ANTITHROMBIN III DEFICIENCY

Abstract

A 37-year-old woman was admitted to the hospital for an early gastric cancer. She was a member of a family who have venous thromboembolic episodes in a high incidence, and had been diagnosed as having hereditary antithrombin III (ATIII) deficiency, with the ATIII activity of 56.8%. This time a distal gastrectomy was performed with a diagnosis of IIc cancer of the angular notch. For perioperative management antithrombin III concentrates were administered and the plasma ATIII level (ATIII activity) was maintained at values in excess of 80% for postoperative one week. No thrombotic complications occurred as judged by clinical examination. It has been confirmed that any operation can increase a risk of association of thrombosis in this congenital disorder. When ATIII consumption is enhanced (for example, during sugical procedures), usual antithrombotic therapies such as administration of heparin are not enough and replacement therapy may be necessary in order to normalize ATIII level.