Disseminated carcinoma diagnosed by bone marrow biopsy in patients with microangiopathic hemolytic anemia and thrombocytopenia: A report of two cases with gastric cancer and a review of the literature

Introduction: Malignancy is often associated with hematological disorders, but rarely is the diagnosis of malignancy secondary to the diagnosis of microangiopathic hemolytic anemia and thrombocytopenia. Case reports: We report hereby two patients with metastatic gastric carcinoma presenting with microangiopathic hemolytic anemia and thrombocytopenia. Despite chemotherapy and repeated plasmapheresis in one patient, both patients succumbed shortly after the diagnosis of cancer was made. Conclusion: A review of the literature regarding microangiopathic hemolytic anemia in cancer patients is discussed. In patients suffering from microangiopathic hemolytic anemia and thrombocytopenia, malignancy should be considered as a possible cause. Early diagnosis of malignancy may be critical for determining the patient's prognosis and potentially avoiding unnecessary overtreatment.