Bone Marrow Metastases as an Initial Presentation of Gastrointestinal Adenocarcinoma: A Case Report

Molina-Arrebola María-Angustias

doi:10.11648/j.cmr.20170604.12

Abstract

Bone marrow metastases as the initial presentation of a solid tumour are uncommon, especially if the primary neoplasm site cannot be identified during the diagnosis presentation despite laboratory testing and imaging techniques. In these situations, bone marrow examination can lead to a final diagnosis of the primary malignancy. We report an unusual case of osteoblastic metastases from an unknown primary site – this was because no relevant lesions were found from either imaging or endoscopic examination. The patient was sent for a bone marrow biopsy, revealing a morphology replaced by glandular structures and an immunohistochemistry consistent with a gastrointestinal origin. Bone marrow examination was the clue to the final diagnosis and led to specific treatment.

Highlights

Metastases are the most common type of malignant tumour involving bone, and the major primary sites are reported to be breast cancer in women and prostate cancer in men
Bone marrow examination is a diagnostic tool more commonly used in hematologic malignancies, yet has been increasingly employed in documenting the metastatic involvement of solid tumours
Given the suspected diagnosis of gastrointestinal been demonstrated that lung cancer cells almost always adenocarcinoma with generalized bone metastases, the patient express TTF-1, so this expression can be used to identify was referred to the Oncology Department

Summary

Introduction

Metastases are the most common type of malignant tumour involving bone, and the major primary sites are reported to be breast cancer in women and prostate cancer in men. In some cases the primary site cannot be identified by systemic examination and the lack of detectable primary neoplasm could delay staging and treatment [1]. Bone marrow examination is a diagnostic tool more commonly used in hematologic malignancies, yet has been increasingly employed in documenting the metastatic involvement of solid tumours. In these cases, the histological findings such as immunohistochemical and other morphological parameters from the bone biopsy can assess the primary cancer diagnosis. The recognition of metastases in random biopsies is a challenge to haematologists and pathologists alike [2, 3]

Case Report

Findings

Discussion

Conclusion