Carcinomatosis Of Bone Marrow Research Articles

Disseminated Carcinomatosis of Bone Marrow with or without an Unknown Primary Site: A Case Series

Disseminated Carcinomatosis of Bone Marrow with or without an Unknown Primary Site: A Case Series

Metronomic cyclophosphamide for bone marrow carcinomatosis in metastatic castration-resistant prostate cancer

PurposeIn some patients with prostate cancer, bone marrow carcinomatosis develops later in the course of the disease, which has a poor prognosis. These are often heavily pretreated patients in the castration-resistant situation for whom there are no other therapeutic options, because either all available systemic therapies have already been used or the use of one is not possible due to the cytopenias associated with bone marrow carcinomatosis. In our literature search, there are no data on this treatment in the setting available, especially no clinical trial or even randomized data. This case series is to determine the clinical efficacy of metronomic cyclophosphamide in patients with metastatic castration-resistant prostate cancer and bone marrow carcinomatosis, particularly with regard to stabilization of the blood count (thrombocytopenias) and thus the possibility of further (more toxic) lines of therapy.MethodsRetrospective unicenter analysis was performed on eleven patients between 54 and 84 years of age on metronomic cyclophosphamide for bone marrow carcinomatosis in metastatic castration-resistant prostate cancer treated at a Swiss cancer center between 2014 and 2023.ResultsEleven patients received metronomic cyclophosphamide for varying periods of time; the majority had severe cytopenias (especially thrombocytopenias). Partially hematologic stabilization was achieved with administration of further systemic therapies.ConclusionOur case series demonstrates that the use of metronomic cyclophosphamide allows hematologic stabilization for months, benefiting patients who had already received all available therapies for metastatic castration-resistant prostate cancer. Alternatively, it may act as bridging therapy to allow consecutive administration of more toxic therapies with proven survival benefit.

FDG PET/CT reveals bone marrow oligometastasis in laryngeal squamous carcinoma: a case report with favorable outcome

Laryngeal carcinoma is the most common head and neck cancer. The vast majority of laryngeal carcinomas are of squamous-cell histologic type. Metastasis of laryngeal cancer typically occurs within the cervical lymph nodes and seldom in other regions. Although a small percentage of patients experience distant metastases, bone marrow metastasis from laryngeal cancer is among the least common metastatic sites. Previous literature has suggested that bone marrow carcinomatosis is aggressive and has a poor outcome, particularly in patients with supraglottic tumors. Ante-mortem diagnosis of this metastatic pattern has been limited. To our knowledge, this case report highlights the first documented occurrence wherein the utilization of 18-fluorine fludeoxyglucose positron emission tomography/CT imaging played a pivotal role in the early detection of bone marrow metastasis in a patient diagnosed with transglottic laryngeal cancer. A solitary metastatic distant bone marrow lesion was identified early during follow-up. As a consequence, the patient exhibited a remarkable and unforeseen favorable clinical outcome.

Invasive lobular carcinoma of the breast detected with real-time virtual sonography: a case report

BackgroundInvasive lobular carcinoma (ILC) sometimes presents with unique clinical, pathologic, and radiographic features. In this case report, we describe a patient with ILC, whose initial presentation consisted with symptoms secondary to bone-marrow dissemination. In addition, the breast primary was revealed only by magnetic resonance imaging (MRI) followed by real-time virtual sonography (RVS).Case presentationA 51-year-old woman presented to our outpatient clinic with dyspnea on exertion. She had severe anemia (hemoglobin, 5.3 g/dL) and thrombocytopenia (platelet count, 31 × 103/mL). Bone-marrow biopsy was performed to evaluate hematopoietic function. The pathologic diagnosis was bone-marrow carcinomatosis due to metastatic breast cancer. Initial mammography followed by ultrasonography (US) failed to detect the primary tumor. On MRI, a non-mass-enhancement lesion was observed. While second-look US also did not detect the lesion, it was clearly visualized with RVS. We were finally able to biopsy the breast lesion. The pathologic diagnosis was ILC positive for both estrogen receptor and progesterone receptor, with 1 + immunohistochemical staining for human epidermal growth factor receptor 2. This case of ILC was characterized by bone-marrow metastasis. Due to decreased cell adhesion, the risk of bone-marrow metastasis is higher in ILC than in invasive ductal carcinoma, the most prevalent type of breast cancer. Biopsy of the primary lesion, which was initially only detected with MRI, was successfully performed with clear visualization during RVS, which is based on the fusion of MRI and US images.ConclusionIn this case report and literature review, we describe the unique clinical characteristics of ILC and a strategy for identifying primary lesions that are initially only visualized with MRI.

Bone marrow carcinomatosis with carcinocythemia clinically mimicking thrombotic thrombocytopenic purpura.

Bone marrow carcinomatosis with carcinocythemia clinically mimicking thrombotic thrombocytopenic purpura.

Immunohistochemical analysis of the distribution of RANKL: a case of disseminated carcinomatosis of bone marrow as the first presentation of relapse in curatively resected colorectal cancer.

Poorly differentiated adenocarcinoma of colorectal carcinoma (CRC) is a rare condition with poor prognosis. In this report, we describe a case of a 69-year-old man who underwent laparoscopic low anterior resection after being diagnosed with stage IIIB CRC. At 10months post-operation, he developed fever and loss of appetite. Laboratory examination revealed > 120.0μg/dL fibrin degradation products and > 60.0μg/dL D-dimer. Bone marrow (BM) examination showed malignant epithelioid infiltrate with CK20 and CDX2 expression, leading to diagnosis of disseminated carcinomatosis of BM, which is rare in CRC and indicative of widespread disease throughout the body. Furthermore, immunohistochemistry revealed high expression of receptor activator of nuclear factor κB ligand (RANKL) in tumor cells, including budding cells of CRC and BM tissues. Thus, RANKL expression, which is known to indicate metastatic behavior of cancer cells, may play a critical role in promoting osteoclast formation, which has been associated with the pathogenesis of BM lesions.

Bone marrow metastasis/carcinomatosis in head and neck squamous cell carcinoma.

Literature on bone marrow carcinomatosis in head and neck squamous cell carcinoma (HNSCC) is sparse. This work aims to augment understanding on its characteristic features, clinical presentation, investigations, treatment and outcomes. Comprehensive literature review of all published cases of metastasis of HNSCC to the bone marrow with regard to clinical presentation, diagnosis, treatment and survival outcomes of this disease. Each of these factors is discussed forming an up-to-date review on the subject. Eight case reports were identified, seven males and one female with an age range of 35-64years. Primary sites were from the oral cavity (n=4), oropharynx (n=3) and supraglottis (n=1). Six were stage four disease with nodal involvement, one case stage two and one case with unknown staging. Two of the oropharyngeal cancers were p16 positive, and one p16 status was not documented. Five patients presented with back pain, two patients had ecchymoses with bleeding, and one presented with sepsis and thrombocytopaenia. Three patients had proven disseminated intravascular coagulation. Four patients were treated with palliative chemoradiotherapy, one had palliative radiotherapy, one had radiotherapy and dendritic cell vaccine immunotherapy, and two died from the disease prior to any treatment. Various facets of presentation and management are discussed. Bone marrow carcinomatosis from HNSCC is rare. It can present with a variety of non-specific symptoms, and a high index of suspicion is required to be able to diagnose the condition promptly. Aggressive chemotherapy is the treatment of choice but prognosis remains poor.

The efficacy and safety of paclitaxel plus bevacizumab therapy in breast cancer patients with visceral crisis

BackgroundVisceral crisis in metastatic breast cancer (MBC) is defined as severe organ dysfunction requiring rapidly efficacious therapy. Although weekly paclitaxel plus bevacizumab (wPTX + BV) achieves a high response rate in human epidermal growth factor receptor 2 (HER2)-negative MBC, the efficacy and safety of wPTX + BV for visceral crisis is unclear. MethodsWe retrospectively investigated patients with MBC with visceral crisis who received wPTX + BV. Visceral crisis was defined as follows: liver dysfunction (aspartate or alanine aminotransferase >200 U/L or total bilirubin >1.5 mg/dl), respiratory dysfunction (carcinomatous lymphangiomatosis, SpO2 <93% in ambient air or required thoracentesis), superior vena cava (SVC) syndrome, or bone marrow carcinomatosis. The primary outcome was the proportion of patients on-treatment with wPTX + BV after 12 weeks. We also investigated time to treatment failure (TTF), overall survival (OS), objective response rate (ORR), and adverse events. ResultsA total of 44 patients with respiratory dysfunction (n = 29), liver dysfunction (n = 10), bone marrow carcinomatosis (n = 7), and SVC syndrome (n = 2) were eligible for this investigation. The proportion of patients on-treatment with wPTX + BV after 12 weeks was 63% (30/44), and the other patients discontinued wPTX + BV because of adverse events (n = 5) and disease progression (n = 9). Median TTF and OS, and the ORR were 131 days and 323 days, and 41%, respectively. No treatment-related death occurred.Conclusion: wPTX + BV achieved favorable efficacy and safety for treating patients with visceral crisis and may therefore be considered an option for the treatment of this acutely severe clinical condition.

Diffuse peritoneal carcinomatosis with ascites and disseminated bone marrow carcinomatosis as initial presentation of occult breast cancer.

Diffuse peritoneal carcinomatosis with ascites and disseminated bone marrow carcinomatosis as initial presentation of occult breast cancer.

Sweat gland carcinoma of the left axilla with disseminated carcinomatosis of the bone marrow

Sweat gland carcinoma of the left axilla with disseminated carcinomatosis of the bone marrow

Disseminated Bone Marrow Carcinomatosis with Disseminated Intravascular Coagulation After Gastrectomy for Advanced Gastric Cancer Successfully Controlled by Treatment with S–1 and Cisplatin: A Case Report

Disseminated Bone Marrow Carcinomatosis with Disseminated Intravascular Coagulation After Gastrectomy for Advanced Gastric Cancer Successfully Controlled by Treatment with S–1 and Cisplatin: A Case Report

Pancytopenia due to massive bone marrow carcinomatosis after radiotherapy for locally advanced breast cancer.

Pancytopenia is a rare complication among patients with breast cancer. Here, we report a case of pancytopenia due to massive bone marrow carcinomatosis (BMC) developed after local radiotherapy following to mastectomy. A 48-year-old woman with locally advanced breast cancer underwent mastectomy and axillary lymph node dissection. During adjuvant chemotherapy, rapidly growing supraclavicular lymph node metastasis was noted, so chemotherapy was discontinued and local radiotherapy was performed. There was no myelosuppression or systemic metastases prior to radiotherapy, but 2 weeks after the completion of radiotherapy, complete blood counts showed pancytopenia, and chest CT scans revealed multiple bone metastasis. A bone marrow biopsy was performed and massive BMC was diagnosed. Despite the best supportive care, her disease progressed rapidly and she died 2months after radiotherapy. Locally advanced breast cancer that is resistant to chemotherapy is at risk of early fatal BMC and should be carefully monitored.

A Case of Bone Marrow Carcinomatosis Developing 6 Months after Surgery for Breast Cancer and Resulting in Rapid Death

A Case of Bone Marrow Carcinomatosis Developing 6 Months after Surgery for Breast Cancer and Resulting in Rapid Death

Slight brightness and osteosclerotic changes of bones on plain X-ray could be clues to the diagnosis of disseminated carcinomatosis of bone marrow.

Clinicians should be alert to the presence of slight brightness and osteosclerotic changes of bones on plain X‐rays, especially in patients without a history of gastric, colon, breast, lung, or prostate cancers, which could lead to the diagnosis of disseminated carcinomatosis of bone marrow.

Leukoerythroblastosis in castration-resistant prostate cancer: A clue to diffuse bone marrow carcinomatosis.

A 66-year-old man with a previous history of advanced prostate cancer failing complete androgen blockade, docetaxel chemotherapy, denosumab, and abiraterone acetate as judged by persistent high serum levels of prostate specific antigen presented with exertional dyspnea, normocytic anemia, and thrombocytopenia. Leukoery - throblastosis was noted in his peripheral blood. Bone marrow examination disclosed diffuse bone marrow carcinomatosis from prostate cancer. Prolonged activated partial thromboplastin time, prothrombin time, and an extremely elevated serum level of Ddimer led to a diagnosis of disseminated intravascular coagulation. Magnetic resonance imaging of spine revealed extensive bone marrow involvement but bone scan showed only scanty bony metastasis. We like to call attention to the importance of prompt bone marrow examination once recognizing leukoerythroblastosis in patients with advanced prostate cancer. Survey of a possible coexistent disseminated intravascular coagulation is as well strongly recommended in this condition.

Treatment outcome of everolimus against neuroendocrine prostate cancer (NEPC).

365 Background: Neuroendocrine prostate cancer (NEPC) is a lethal disease subset with median overall survival of less than 1 year from time of detection. The treatment strategy against NEPC is not yet established. Some clinical trials are ongoing now. Recently, clinical trial (RADIIANT4) showed that treatment with everolimus was associated with significant improvement in survival in patients with progressive lung or gastrointestinal neuroendocrine tumors. And FDA approved new indication for everolimus for progressive, nonfunctional GI and lung neuroendocrine tumors last year. In this study we tried to introduce everolimus against pathologically proven NEPC and investigated the clinical outcomes of this agent. Methods: Total of seven cases were included in this study. All cases were proven the existence of neuroendocrine prostate cancer pathologically. Everolimus (10mg/d) were introduced into all cases. We investigated the neuroendocrine tumor markers (neuron-specific enolase: NSE, and pro-gastrin-releasing peptide: pro GRP), radiologic examination and survival. Results: The median follow up period was 6 months. At least one of the tumor markers increased above normal limit in all cases. NSE increased in four cases, pro GRP increased in five cases and both markers increased in two cases. Tumor markers decreased in five of seven (71.4%) cases (NSE: 2 of 4 cases, pro GRP: 4 of 5 cases) after introduction of everolimus. Median decreasing rate were 67.1% in NSE and 65.5% in pro GRP. Two of seven (28.6%) cases progressed in radiologic examination and died from prostate cancer. One case was very advanced disease and everolimus was introduced after failure of systemic chemotherapy (CDDP + etoposide). Another case was advanced disease with bone marrow carcinomatosis. In terms of adverse event, 4 cases had stomatitis and one case had hyperglycemia. Conclusions: In this study, evelolimus showed efficacy against NEPC. It decreased tumor markers and stabilized the tumor status. Although this study was retrospective and number of cases was limited, there is a possibility that evelolimus would be a one of the treatment options against NEPC.

Gastric adenocarcinoma with bone marrow carcinomatosis complicated with cancer related thrombotic microangiopathy: A case report

Gastric adenocarcinoma with bone marrow carcinomatosis complicated with cancer related thrombotic microangiopathy: A case report

Isolated bone marrow carcinomatosis: A rare presentation of poorly differentiated adenocarcinoma of the stomach in a young male.

Isolated bone marrow carcinomatosis: A rare presentation of poorly differentiated adenocarcinoma of the stomach in a young male.

印環細胞癌成分の胃転移と播種性骨髄癌症を伴った乳腺浸潤性小葉癌の1例

症例は72歳，女性．腰痛と食欲不振を認め，当院を受診した．その際，左乳房の変形を指摘され，当科を紹介された．初診時から高度の貧血とDICを認めた．乳房の針生検では，Indian file patternを呈する印環細胞癌が混ざる乳腺浸潤性小葉癌であった．胃内視鏡検査ではタコイボ様びらんを認め，FDG-PETでは体幹骨中心にびまん性の集積を認め，胃と骨髄の生検から印環細胞癌を認めた．胃の生検組織を免疫染色したところERが陽性，乳腺粘液で陽性を示すMUC1は陽性，胃型粘液で陽性を示すMUC5ACは陰性であったため，胃病変は乳腺浸潤性小葉癌からの転移と診断したが，発症から約1カ月，初診から約2週間後に永眠された．今回，急速な転帰をたどった印環細胞癌による胃転移と播種性骨髄癌症を伴った乳腺浸潤性小葉癌を経験したので報告する．

Disseminated Carcinomatosis of Bone Marrow Due to Sigmoid Colon Cancer

Introduction: Disseminated carcinomatosis of the bone marrow (DCBM) caused by colorectal cancer is rarely seen. DCBM is often accompanied with diffuse intravascular coagulation (DIC). Presentation Of Case: A 72-year-old male patient with a history of right nephrectomy three decades ago for referred benign disease, underwent sigmoid colon resection for cancer causing bowel obstruction. The preoperative evaluation revealed elevated values of CA 19-9 and PSA, with no metastatic lesions in abdominal CT. On eighth postoperative day, the patient developed fever with anemia and thrombocytopenia. Bone marrow examination revealed disseminated carcinomatosis caused by colon cancer. The patient deceased on the twenty seventh postoperative day due to the rapid progression of the accompanied disseminated intravascular coagulation. Discussion: Prognosis for patients with cancer who develop disseminated carcinomatosis of bone marrow (DCBM) is poor. Conclusion: In our case, the rapid deterioration of the patient gave us no option for adjuvant chemotherapy. The outcome was fatal. A 72-year-old male patient with a history of right nephrectomy for benign disease underwent sigmoid colon resection for bowel obstruction due to cancer. Tumor markers CA 19-9 and PSA were elevated, with no metastatic lesions in abdominal CT of admission. On eighth postoperative day, the patient developed severe anemia and thrombocytopenia. Bone marrow examination revealed disseminated carcinomatosis caused by colon cancer. The patient deceased on the twenty seventh postoperative day due to the rapid progression of the accompanied disseminated intravascular coagulation.