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Fujita K, Okubo A, Nakamura T, Takeuchi N. Disseminated carcinomatosis of the bone marrow caused by granulocyte colony-stimulating factor: A case report and review of literature. World J Gastrointest Oncol 2022; 14:2077-2084. [PMID: 36310701 PMCID: PMC9611438 DOI: 10.4251/wjgo.v14.i10.2077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/08/2022] [Accepted: 08/21/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Disseminated carcinomatosis of the bone marrow (DCBM) is a widespread metastasis with a hematologic disorder that is mainly caused by gastric cancer. Although it commonly occurs as a manifestation of recurrence long after curative treatment, the precise mechanism of relapse from dormant status remains unclear. Granulocyte colony-stimulating factor (G-CSF) can promote cancer progression and invasion in various cancers. However, the potential of G-CSF to trigger recurrence from a cured malignancy has not been reported.
CASE SUMMARY A 55-year-old Japanese woman was diagnosed with Ewing sarcoma localized on the fifth lumbar vertebrae 6 years after curative gastrectomy for T1 gastric cancer. After palliative surgery to release nerve compression, pathological diagnosis of the resected specimen was followed by curative radiation and chemotherapy. During treatment, G-CSF was administered 32 times for severe neutropenia prophylaxis. Eight months after completing definitive treatment, she complained of severe back pain and was diagnosed as multiple bone metastases with DCBM from gastric cancer. Despite palliative chemotherapy, she died of disseminated intravascular coagulation 13 d after the diagnosis. Immunohistochemical examination of the autopsied bone marrow confirmed a diffuse positive staining for the G-CSF receptor (G-CSFR) in the relapsed gastric cancer cell cytoplasm, whereas the primary lesion cancer cells showed negative staining for G-CSFR. In this case, G-CSF administration may have been the key trigger for the disseminated relapse of a dormant gastric cancer.
CONCLUSION When administering G-CSF to cancer survivors, recurrence of a preceding cancer should be monitored even after curative treatment.
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Affiliation(s)
- Kengo Fujita
- Department of Medical Oncology, Ina Central Hospital, Nagano 396-8555, Japan
| | - Ayaka Okubo
- Department of Medical Oncology, Ina Central Hospital, Nagano 396-8555, Japan
| | - Toshitsugu Nakamura
- Department of Diagnostic Pathology, Ina Central Hospital, Nagano 396-8555, Japan
| | - Nobumichi Takeuchi
- Department of Medical Oncology, Ina Central Hospital, Nagano 396-8555, Japan
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Okumura T, Mitsui K, Daikuhara S, Tatai T, Itagaki H, Miyabayashi H, Gibo Y. Disseminated Carcinomatosis of Bone Marrow as the Initial Presentation of Intrahepatic Cholangiocarcinoma without Jaundice: An Autopsy Case Report. Intern Med 2022; 61:657-662. [PMID: 34483207 PMCID: PMC8943367 DOI: 10.2169/internalmedicine.7688-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Disseminated carcinomatosis of the bone marrow (DCBM) is often accompanied by disseminated intravascular coagulation (DIC) and has a poor prognosis. DCBM develops most frequently in gastric cancer and is rarely associated with intrahepatic cholangiocarcinoma. A 41-year-old man was incidentally found to have DIC on his regular visit for ulcerative colitis and was diagnosed with DCBM with intrahepatic cholangiocarcinoma. He received intensive care, including chemotherapy, but died suddenly from hyperkalemia, possibly due to tumor lysis syndrome (TLS). The autopsy showed the periductal infiltrating type of intrahepatic cholangiocarcinoma and tumor necrosis, possibly due to chemotherapy, indicating the effectiveness of chemotherapy for DCBM with intrahepatic cholangiocarcinoma.
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Affiliation(s)
- Taiki Okumura
- Department of Gastroenterology, National Hospital Organization Matsumoto Medical Center, Japan
| | - Kenta Mitsui
- Department of Gastroenterology, National Hospital Organization Matsumoto Medical Center, Japan
| | - Seiichi Daikuhara
- Department of Gastroenterology, National Hospital Organization Matsumoto Medical Center, Japan
| | - Toshiharu Tatai
- Department of Gastroenterology, National Hospital Organization Matsumoto Medical Center, Japan
| | - Hiroko Itagaki
- Department of Pathology, National Hospital Organization Matsumoto Medical Center, Japan
| | - Hideharu Miyabayashi
- Department of Gastroenterology, National Hospital Organization Matsumoto Medical Center, Japan
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Namikawa H, Takemoto Y, Makuuchi A, Kobayashi M, Kinuhata S, Morimura M, Ikebe T, Tanaka H, Shuto T. Disseminated carcinomatosis of the bone marrow from pancreatic cancer: a case report. BMC Cancer 2016; 16:801. [PMID: 27769217 PMCID: PMC5075151 DOI: 10.1186/s12885-016-2849-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 10/10/2016] [Indexed: 04/16/2023] Open
Abstract
Background Most cases of disseminated carcinomatosis of the bone marrow (DCBM) arise from gastric cancer. DCBM from pancreatic cancer is very rare. We herein present a case of DCBM from pancreatic cancer. Case presentation A 57-year-old man was referred to our hospital for severe lumbago. Laboratory data indicated that he suffered from disseminated intravascular coagulation (DIC). Non-contrast abdominal computed tomography (CT) revealed multiple bone masses but no other abnormal findings. Left iliac bone marrow biopsy revealed poorly differentiated adenocarcinoma cells. Positron emission tomography (PET)-CT showed diffuse abnormal uptake in the bones and tail of the pancreas. Contrast whole-body CT showed a tumor measuring approximately 28 mm in diameter with poor enhancement in the tail of the pancreas. The patient’s final diagnosis was pancreatic cancer located in the tail of the pancreas with diffuse bone metastases and DIC. His DCBM was thus believed to originate from the pancreatic cancer. He succumbed to the disease approximately 2 months after admission to our hospital. Conclusion We herein describe a case of pancreatic cancer located in the tail of the pancreas with diffuse bone metastases and DIC, which, in our case, was DCBM. Therefore, in cases of DCBM with an unknown primary tumor, pancreatic cancer should be considered during differential diagnosis.
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Affiliation(s)
- Hiroki Namikawa
- Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Yasuhiko Takemoto
- Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Ayako Makuuchi
- Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Masanori Kobayashi
- Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Shigeki Kinuhata
- Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Mina Morimura
- Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Takashi Ikebe
- Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.,Department of Emergency and General Practice, Higashi Sumiyoshi Morimoto Hospital, 3-2-66, Takaai, Higashisumiyoshi-ku, Osaka, 546-0014, Japan
| | - Hiromu Tanaka
- Department of Palliative Care, Higashi Sumiyoshi Morimoto Hospital, 3-2-66, Takaai, Higashisumiyoshi-ku, Osaka, 546-0014, Japan
| | - Taichi Shuto
- Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
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Iguchi H. Recent aspects for disseminated carcinomatosis of the bone marrow associated with gastric cancer: What has been done for the past, and what will be needed in future? World J Gastroenterol 2015; 21:12249-12260. [PMID: 26604634 PMCID: PMC4649110 DOI: 10.3748/wjg.v21.i43.12249] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 07/24/2015] [Accepted: 10/26/2015] [Indexed: 02/07/2023] Open
Abstract
Disseminated carcinomatosis of the bone marrow is characterized by widespread bone metastasis (bone marrow infiltration) from solid tumors with hematological disorders coexisted. This disease is frequently complicated with gastric cancer among solid tumors although its incidence is very rare. In recent years, technological innovations in diagnosis and treatment for cancer have remarkably improved, which made survival rates of various cancers prolonged. Prognosis of disseminated carcinomatosis of the bone marrow associated with gastric cancer, however, is still poor (less than a year), possibly because this disease has not been given attention due to low incidence. In this review, I summarize the results obtained for the past, and propose ways to improve the prognosis of this disease.
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