A case of disseminated carcinomatosis of the bone marrow from gastric cancer developing rapidly after a gastrectomy

Abstract

Background Disseminated carcinomatosis of the bone marrow (DCBM) is often associated with disseminated intravascular coagulation (DIC) and a poor prognosis. Moreover, the timing of the diagnosis varies. We presented herein the first report of a case of DCBM from gastric cancer that developed rapidly after a gastrectomy. Case presentation A 42-year-old male patient was referred to us for gastric cancer. Preoperative laboratory tests were normal. Abdominal computed tomography (CT) revealed no obvious bone metastasis, and he underwent a laparoscopic distal gastrectomy. On postoperative day (POD) 1, laboratory data indicated severe thrombocytopenia. Postoperative bleeding requiring reoperation was found. Afterwards, he complained of lower back pain. His ALP and LDH gradually became elevated. On POD 8, DIC was diagnosed. CT and bone scintigraphy showed multiple, widespread bone metastases. Based on these findings, DCBM from gastric cancer was diagnosed. Systemic chemotherapy was started on POD 12. The DIC subsided during the first course, and he was discharged on POD 21. The patient died of tumor progression 7 months later. Conclusion When thrombocytopenia is observed immediately after a gastrectomy for gastric cancer, the possibility of DCBM should be considered.

An autopsy case of disseminated carcinomatosis of the bone marrow from esophageal adenocarcinoma

“…Recently, the successful treatment of DCBM from various malignancies has been reported. In the past 3 years, two English‐language papers have reported that anticoagulation and chemotherapy for DCBM from gastrointestinal adenocarcinoma have led to the discharge of patients from the hospitals 21,22 …”

“…In the past 3 years, two English-language papers have reported that anticoagulation and chemotherapy for DCBM from gastrointestinal adenocarcinoma have led to the discharge of patients from the hospitals. 21,22 Disseminated carcinomatosis of the bone marrow is associated with a high rate of DIC, and its prognosis is very poor. Aggressive treatment of malignancy improves DCBM prognosis.…”

Differentiation Between Disseminated Carcinomatosis of the Bone Marrow From Urothelial Cancer and Intravascular Large B-cell Lymphoma: A Case Report

“…This condition is characterized by the widespread dissemination of cancer cells within the bone marrow, affecting the normal hematopoiesis process and leading to a variety of systemic symptoms [ 3 ]. While most cases of disseminated carcinomatosis of the bone marrow are associated with primary malignancies of the prostate, lung, breast, and stomach, instances stemming from urothelial cancer, mainly originating from sigmoid colon cancer, are notably rare [ 4 , 5 ]. The differentiation from intravascular lymphoma, the frequency of which is also rare with less than one in one million general population, is challenging, especially when patients’ conditions are critical and adequate investigations are impossible [ 6 ].…”