TNF and neoplasm: The direct activation of the coagulation cascade and platelets cause the release of cytokines including tumor necrosis factor-alpha (TNF-a) and interleukin-1b (IL-1b) from the tumor cells, greatly influencing the formation of plasminogen activator inhibitor (PAI-1), which acts as an inhibiting factor for fibrinolysis, indirectly promoting thrombogenesis during malignancy [5].