Bone Marrow Metastases as an Initial Presentation of Gastrointestinal Adenocarcinoma: A Case Report
Clinical Medicine Research
Volume 6, Issue 4, July 2017, Pages: 127-130
Received: Feb. 13, 2017;
Accepted: Apr. 24, 2017;
Published: Jun. 14, 2017
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Molina-Arrebola María-Angustias, Department of Biotechnology, Haematology and Haemotherapy Unit, Poniente Hospital, Almería, Spain
Fernández-Caballero Mariana, Department of Biotechnology, Haematology and Haemotherapy Unit, Poniente Hospital, Almería, Spain
Avivar-Oyonarte Cristóbal, Department of Biotechnology, Poniente Hospital, Almería, Spain
Jiménez-Cortés María-Carmen, Department of Biotechnology, Pathology Unit, Poniente Hospital, Almería, Spain
Hidalgo-Rico María-Angeles, Department of Internal Medicine, Pulmonology Unit, Poniente Hospital, Almería, Spain
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.
Bone Marrow Metastases as an Initial Presentation of Gastrointestinal Adenocarcinoma: A Case Report, Clinical Medicine Research.
Vol. 6, No. 4,
2017, pp. 127-130.
Piccioli A, Maccauro G, Spinelli MS, Biagini R, Rossi B. Bone metastases of unknown origin: epidemiology and principles of management. Journal of Orthopaedics and Traumatology. 2015.
Papac RJ. Bone marrow metastases. A review. Cancer 1994; 74: 2403–13.
Mohanty SK, Dash S. Bone marrow metastasis in solid tumors. Indian J Pathol Microbiol 2003; 46: 613–6.
Piccioli A. Breast cancer bone metastases: an orthopedic emergency. J Orthop Traumatol 2014; 15: 143–4.
Katagiri H, Takahashi M, Inagaki J, Sugiura H, Ito S, Iwata H. Determining the site of the primary cancer in patients with skeletal metastasis of unknown origin: a retrospective study. Cancer 1999; 86: 533–7.
Wedin R, Bauer HC, Skoog L, Söderlund V, Tani E. Cytological diagnosis of skeletal lesions. Fine-needle aspiration biopsy in 110 tumours. J Bone Joint Surg Br 2000; 82: 673–8.
Ozkalemkas F, Ali R, Ozkocaman V, Ozcelik T, Ozan U, Ozturk H, Kurt E, Evrensel T, Yerci O, Tunali A. The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: a clinical study of 19 cases. BMC Cancer 2005; 5: 144.
Singh G, Krause JR, Breitfeld V. Bone marrow examination: for metastatic tumor: aspirate and biopsy. Cancer 1977; 40: 2317–21.
Chu P, Wu E, Weiss LM. Cytokeratin 7 and cytokeratin 20 expression in epithelial neoplasms: a survey of 435 cases. Mod Pathol 2000; 13: 962–72.
Kitamura H, Yazawa T, Sato H, Okudela K, Shimoyamada H. Small cell lung cancer: significance of RB alterations and TTF-1 expression in its carcinogenesis, phenotype, and biology. Endocr Pathol 2009; 20: 101–7.
Cuzick J, Thorat MA, Andriole G, Brawley OW, Brown PH, Culig Z, Eeles RA, Ford LG, Hamdy FC, Holmberg L, Ilic D, Key TJ, Vecchia C La, Lilja H, Marberger M, Meyskens FL, Minasian LM, Parker C, Parnes HL, Perner S, et al. Prevention and early detection of prostate cancer. The Lancet Oncology. 2014.
Mostofi FK, Davis CJ, Sesterhenn IA. Pathology of carcinoma of the prostate. Cancer Wiley Subscription Services, Inc., A Wiley Company; 1992; 70: 235–53.
Swords DS, Firpo MA, Scaife CL, Mulvihill SJ. Biomarkers in pancreatic adenocarcinoma: current perspectives. Onco Targets Ther Dove Press; 2016; 9: 7459–67.
Mishra P, Das S, Kar R, Jacob SE, Basu D. Non-haematopoietic malignancies metastasing to the bone marrow: a 5 year record-based descriptive study from a tertiary care centre in South India. Indian J Cancer 2014; 51: 30–4.
Yun HK, Shin MG, Bo D, Kim DW, Cho D, Shin JH, Suh SP, Ryang DW. [Laboratory evaluation of bone marrow metastasis: single institute study]. Korean J Lab Med 2007; 27: 96–101.
Hemminki K, Riihimäki M, Sundquist K, Hemminki A. Site-specific survival rates for cancer of unknown primary according to location of metastases. Int J Cancer 2013; 133: 182–9.
Chung YS, Choi TY, Ha CY, Kim HM, Lee KJ, Park CH, Fitzpatr LA. An Unusual Case of Osteoblastic Metastasis from Gastric Carcinoma. Yonsei Med J 2002; 43: 377.
Nishidoi H, Koga S. [Clinicopathological study of gastric cancer with bone metastasis]. Gan To Kagaku Ryoho 1987; 14: 1717–22.
Katoh M, Unakami M, Hara M, Fukuchi S. Bone metastasis from colorectal cancer in autopsy cases. J Gastroenterol 1995; 30: 615–8.
Borad MJ, Saadati H, Lakshmipathy A, Campbell E, Hopper P, Jameson G, Von Hoff DD, Saif MW. Skeletal metastases in pancreatic cancer: a retrospective study and review of the literature. Yale J Biol Med 2009; 82: 1–6.
Roa JC, Aretxabala X de, Melo A, Faría G, Araya JC, Villaseca MA, Guzmán P, Roa I. [Detection of bone marrow micrometastases in patients with gallbladder cancer]. Rev Med Chil 2004; 132: 1489–98.