Treatment of Rectal Cancer-Induced Disseminated Carcinomatosis of the Bone Marrow with FOLFOX plus Cetuximab and Panitumumab

Ehara, Takehito; Kitazawa, Masato; Hondo, Nao; Takahata, Shugo; Yamamoto, Yuta; Koyama, Makoto; Okumura, Motohiro; Nakamura, Satoshi; Tokumaru, Shigeo; Muranaka, Futoshi; Miyagawa, Yusuke; Soejima, Yuji

doi:10.1159/000505323

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…Subsequently, systemic chemotherapy should be initiated if possible, in order to control the metastatic disease which is the underlying cause of the haematological disorder. There have been case reports of successful treatment with XELOX and FOLFOX based regime with bevacizumab or cetuximab as adjuvant therapy 4,5,8–11,13,14,16 …”

Section: Discussionmentioning

confidence: 99%

“…There have been case reports of successful treatment with XELOX and FOLFOX based regime with bevacizumab or cetuximab as adjuvant therapy. 4,5,[8][9][10][11]13,14,16 In the subset of patients who may be too frail or otherwise deemed unsuitable for chemotherapy, palliation would be the best course of action. Goals of care should be discussed early in this aggressive disease and symptomatic medications including opioids should be administered early and titrated to the patient's symptoms.…”

Section: Prognosis and Consideration Of Systemic Chemotherapymentioning

confidence: 99%

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Systematic review of isolated disseminated carcinomatosis of bone marrow from colorectal cancer

Chan

Lin

Tay

et al. 2023

ANZ Journal of Surgery

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Background: Colorectal cancer (CRC) metastasis commonly occurs in the liver and lungs with bone metastasis rarely occurring in isolation. Disseminated carcinomatosis of bone marrow (DCBM) is extremely rare in CRC. We conducted a systematic review to provide more information on the diagnosis, treatment options, and prognosis of the condition. Methods: Studies were identified by performing searches on MEDLINE and EMBASE electronic databases according to the PRISMA statement standards. We included a single patient whom we treated for metastatic CRC presenting with DCBM in our study. Statistical analysis was performed using SPSS software version 23.0. Results: A search through 5502 unique studies yielded 14 studies that were eventually included. There was a total of 17 cases of DCBM in CRC with back pain and constitutional symptoms as the most common presenting complaints. DCBM in CRC was associated with markedly elevated CEA of 275.57 (95% CI 17.13-534.00). There was no predilection for site of primary tumour. Overall median survival was 120 days (95% CI 64.43-175.58). The median survival for patients who received chemotherapy was 240 days (95% CI 71.11-408.89), as compared to 9 days (95% CI 1.80-16.20) for patients who received best supportive treatment. Conclusion: DCBM from CRC is extremely rare. Bone marrow examination remains the gold standard for diagnosis. Colonic stenting or surgical diversion may be more appropriate than primary resection in obstructed CRC in view of the poor prognosis. Systemic chemotherapy shows promise in increasing median survival.

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Section: Discussionmentioning

confidence: 99%

Section: Prognosis and Consideration Of Systemic Chemotherapymentioning

confidence: 99%

Systematic review of isolated disseminated carcinomatosis of bone marrow from colorectal cancer

Chan

Lin

Tay

et al. 2023

ANZ Journal of Surgery

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“…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 …”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Suzuki,

Meguro,

Furusawa

et al. 2023

Clinical Case Reports

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Key Clinical MessageDisseminated carcinomatosis of the bone marrow is rare. We present such a case, which is useful for raising awareness about the importance of early diagnosis and treatment of carcinomas complicated by disseminated carcinomatosis of the bone marrow.AbstractThis is the first autopsy report of disseminated carcinomatosis of the bone marrow (DCBM) in esophageal adenocarcinoma. Advanced poorly differentiated adenocarcinoma with signet ring cell carcinoma arising in Barrett's esophagus caused disseminated intravascular coagulation (DIC) with extensive bone marrow metastasis, resulting in death from cerebral hemorrhage. Although DCBM due to malignancy is rare with poor prognosis, it should be considered in malignancies associated with DIC, and prompt initiation of chemotherapy is the only way to improve the patient's prognosis.

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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

et al. 2022

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

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Treatment of Rectal Cancer-Induced Disseminated Carcinomatosis of the Bone Marrow with FOLFOX plus Cetuximab and Panitumumab

Cited by 4 publications

References 17 publications

Systematic review of isolated disseminated carcinomatosis of bone marrow from colorectal cancer

Systematic review of isolated disseminated carcinomatosis of bone marrow from colorectal cancer

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

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

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