Metastatic tumors in bone marrow: histopathology and advances in the biology of the tumor cells and bone marrow environment

Cotta, Claudiu V.; Konoplev, Sergej; Medeiros, L. Jeffrey; Bueso‐Ramos, Carlos E.

doi:10.1016/j.anndiagpath.2006.04.001

Cited by 25 publications

(11 citation statements)

References 136 publications

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“…However, these techniques are not yet routinely applied or standardized. Furthermore, the prognostic impact of low-burden BM metastatic spread is still controversial [8] [12] and their effect on the therapeutic approach remains unclear [13].…”

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confidence: 99%

Predictive Value of Clinical and Laboratory Parameters for Overt Bone Marrow Metastasis in Patients with Solid Malignancy

Filanovsky¹,

Feldberg²,

Miller³

et al. 2017

JCT

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Bone marrow (BM) metastases are known to worsen the outcome in patients with malignancies and alter the choice of the treatment regimen. In an attempt to identify routine parameters for the prediction of BM metastasis we evaluated the clinical and laboratory data of 103 patients with metastatic solid tumors. We also assessed which of these factors appeared to influence survival. Three laboratory abnormalities were found to be predictive of metastasis on BM biopsy: thrombocytopenia < 50 × 10 9 /L OR 14.4; p = 0.02; hypocellular or dry tap aspirate OR 7.0; p = 0.02 and high serum alkaline phosphatase OR 6.5; p = 0.03. Three additional factors were found to be associated with deceased survival. Thrombocytopenia was associated with decreased survival from a median of 0.8 months to 4.1 months, p < 0.0001. Serum LDH levels more than twice the upper limit of normal were also reduced survival from 1.8 months versus 4.7 months, p = 0.03. Finally, the initial diagnosis of malignancy by bone marrow examination was associated with reduced survival from 1.8 months vs. 4.0 months, p = 0.03 in individuals where BM metastases were not the presenting feature of malignancies. Use of these simple clinical parameters may help in the early diagnosis of bone marrow metastases and improve clinical approach.

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confidence: 99%

Predictive Value of Clinical and Laboratory Parameters for Overt Bone Marrow Metastasis in Patients with Solid Malignancy

Filanovsky¹,

Feldberg²,

Miller³

et al. 2017

JCT

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“…But on the other hand, it was claimed that in the skeletal bones, the frequency of micrometastasis was higher than was found by bone scans and radiographs [7]. Hashimoto et al, reported that, in the mandible, there exist the microscopic deposits of metastatic tumour cells which were not identified in routine radiographic examinations.…”

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confidence: 99%

Osteosarcoma of the Jaws: Case Report on Synchronous Multicentric Osteosarcomas

Jia

2014

JCDR

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A 61-year-old female who had bilateral cystic lesions in her mandible was diagnosed ten months ago, at a local hospital. She complained that she had felt no pain or numbness in her teeth and mandible. Also, she claimed that she had suffered from no tumours or systemic diseases before. Afterwards, a panoramic X-ray was taken, which revealed some radiolucent lesions that were located bilaterally in her posterior mandible. The result showed that the cystic expansion was surrounded by well-defined cortical margins Each cystic lesion contained an un-erupted mandibular third molar. There was no evidence of root-restoration in the adjacent molar teeth .According to the first panoramic X-ray examination, the presumptive result of clinical diagnosis was a dentigerous cyst. Then, the patient was initially treated with bilateral curettage in the local hospital. Meanwhile, an incisional biopsy was taken during the first surgery. The histology of the first biopsy showed a piece of cyst-like tissue, which was lined by non-keratinizing, squamous epithelium [Table/ Fig-1b]. But the stromal necrosis was apparent. The histologic diagnosis of the first biopsy was a cystic lesion which was lined by non-keratinizing, squamous epithelium.Two months after the curettage, the patient was referred to Peking University School and Hospital of Stomatology, after she complained of a mass on the right inferior gingiva that bled painlessly. Another panoramic X-ray was taken, which demonstrated a well-healed left lesion while the right lesion had become a mixed, radiolucentradio opaque mass with a diffuse and irregular borderline [Table/ Fig-2]. Therefore, a second incisional biopsy was performed. The second biopsy specimen was a piece of bone-like hard tissue. Histopathology showed many atypical cells which were embedded in poorly calcified region and the nuclear fission had increased. This time, a histologic diagnosis of a low-differentiated sarcoma was made preoperatively. In order to investigate the original site of the sarcoma, further Positron Emission Computed Tomography (PET/ CT) and Emission Computed Tomography (ECT) were performed. PET/CT demonstrated an enhancing red mass, both in the right mandible and in the left pelvis. The left pelvis had multiple abnormal masses in the left ilium, pubis, ischial and acetabular regions . ECT showed that an imaging agent was deposited in the right mandible and in the left pelvis. Both the PET/CT and the ECT indicated that the patient had a malignant tumour in her left pelvis. After the general physical checkup, the patient recalled that she had been suffering from hip pain since past two years. This "indisposition" had been ignored by her earlier, as she had been apprehensive that it had been post-menopausal osteoporosis. However, it could have been reasonably attributable to the tumour which had been identified. The radical operation of hemi-dilectomy was performed [Table/ Fig-4a,4b]. The specimen showed that the tumour had originated from the bone. It was invasive, pale and expanded to the surfa...

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“…more commonly associated with breast, prostate, and small cell lung carcinomas in adults, and neuroblastomas, rhabdomyosarcomas,andEwing'sfamilyoftumorsinchildren [2]. Clinicalmanifestationsarenotspecific,butbonepain,generalizedorconfinedtotheback,isafrequentcomplaint.Hematological abnormalities are frequent including thrombocytopenia,anemiawithfrequentanisopoïkilocytosis,andleucopenia.…”

Section: Disclosure Statementmentioning

confidence: 99%

Bone Marrow Metastases in a Patient with Primary Mediastinal Non-Seminomatous Germ Cell Tumor – an Unusual Pattern of Relapse

Garbay¹,

Durrieu

Bui³

et al. 2012

Onkologie

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Background: Bone marrow is a very unusual site of metastasis for germ cell tumors. Case Report: We report the case of a 21-year-old male patient who was treated with chemotherapy and secondary surgery for a primary mediastinal non-seminomatous germ cell tumor (NSGCT). The patient achieved complete remission. However, 4 months after completion of therapy, he complained of rapidly worsening bone pain. No evidence for disease relapse was found in the computed tomography scan of thorax and abdomen, magnetic resonance imaging of the spine, or bone scan. A blood test revealed pancytopenia and elevated serum tumor markers. A bone marrow aspirate showed infiltration by tumor cells positive for AE1/AE3 and AFP confirming the diagnosis of isolated bone marrow metastatic relapse. Salvage chemotherapy was started and resulted in a rapid decrease of serum tumor markers. However, pancytopenia did not improve and the patient died of severe sepsis 3 weeks later. Conclusion: We report here the first case of isolated bone marrow metastatic relapse of an NSGCT. 2 other cases of bone marrow metastasis in patients with NSGCT have been reported. In these 2 cases, as in our patient, the primary site was not testicular but mediastinal suggesting a non-fortuitous association.

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Metastatic tumors in bone marrow: histopathology and advances in the biology of the tumor cells and bone marrow environment

Cited by 25 publications

References 136 publications

Predictive Value of Clinical and Laboratory Parameters for Overt Bone Marrow Metastasis in Patients with Solid Malignancy

Predictive Value of Clinical and Laboratory Parameters for Overt Bone Marrow Metastasis in Patients with Solid Malignancy

Osteosarcoma of the Jaws: Case Report on Synchronous Multicentric Osteosarcomas

Bone Marrow Metastases in a Patient with Primary Mediastinal Non-Seminomatous Germ Cell Tumor – an Unusual Pattern of Relapse

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