Disseminated Carcinomatosis of Bone Marrow Due to Sigmoid Colon Cancer

Christos Konstantinidis^1, , Panagiotis Varsos¹ and Sotirios Kympouris^1,

¹Surgical Department, Hippocratio General Hospital of Athens, 114 Vasilissis Sofias str, Athens, Region of Attica, Greece

Cite this paper:
Christos Konstantinidis, Panagiotis Varsos and Sotirios Kympouris. Disseminated Carcinomatosis of Bone Marrow Due to Sigmoid Colon Cancer. American Journal of Medical Case Reports. 2015; 3(4):102-104. doi: 10.12691/ajmcr-3-4-4

Abstract

Introduction: Disseminated carcinomatosis of the bone marrow (DCBM) caused by colorectal cancer is rarely seen. DCBM is often accompanied with diffuse intravascular coagulation (DIC). Presentation Of Case: A 72-year-old male patient with a history of right nephrectomy three decades ago for referred benign disease, underwent sigmoid colon resection for cancer causing bowel obstruction. The preoperative evaluation revealed elevated values of CA 19-9 and PSA, with no metastatic lesions in abdominal CT. On eighth postoperative day, the patient developed fever with anemia and thrombocytopenia. Bone marrow examination revealed disseminated carcinomatosis caused by colon cancer. The patient deceased on the twenty seventh postoperative day due to the rapid progression of the accompanied disseminated intravascular coagulation. Discussion: Prognosis for patients with cancer who develop disseminated carcinomatosis of bone marrow (DCBM) is poor. Conclusion: In our case, the rapid deterioration of the patient gave us no option for adjuvant chemotherapy. The outcome was fatal. A 72-year-old male patient with a history of right nephrectomy for benign disease underwent sigmoid colon resection for bowel obstruction due to cancer. Tumor markers CA 19-9 and PSA were elevated, with no metastatic lesions in abdominal CT of admission. On eighth postoperative day, the patient developed severe anemia and thrombocytopenia. Bone marrow examination revealed disseminated carcinomatosis caused by colon cancer. The patient deceased on the twenty seventh postoperative day due to the rapid progression of the accompanied disseminated intravascular coagulation.

Keywords:
sigmoid colon cancer obstruction disseminated carcinomatosis disseminated intravascular coagulation

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

Figures

References:

[1]	Naito M, Yoshida Y, Aisu N, Tanimura S, Hoshino S, Tanaka T, Nimura S, Tamura K, Yamashita Y. A report of disseminated carcinomatosis of the bone marrow originating from transverse colon cancer successfully treated with chemotherapy using XELOX plus bevacizumab. Case Rep Oncol 2014; 7: 426-434.
[2]	Takeda H, Nishikawa H, Tsumura T, Sekikawa A, Maruo T, Okabe Y, Kimura T, Wakasa, Osaki Y. Prominent hypereosinophilia with disseminated intravascular coagulation as an unusual presentation of advanced gastric cancer. Intern Med 53: 563-569, 2014.
[3]	Yee Chao Y, Teng HC, Hung HC, King KC, Li CP, Chi KH, Sang-Hue Yen SH, Chang FY. Successful initial treatment with weekly etoposide, epirubicin, cisplatin, 5-Fluorouracil and leucovorin chemotherapy in advanced gastric cancer patients with disseminated intravascular coagulation. Jpn J Clin Oncol (2000) 30 (3): 122-125.
[4]	Suzuki H, Matsuoka N, Ushimaru Y, Kakimoto Y, Toyoda A, Endo Y, Murakami O, et al. A case of disseminated carcinomatosis of the bone marrow with disseminated intravascular coagulation caused by advanced colon cancer successfully treated with SOX/bevacizumab. Gan To Kagaku Ryoho 2014 Aug; 41 (8): 1013-6.
[5]	Ganno H, Nagahama T, Fukuda A, Takeuchi S, Fujiya K, Amagasa H, Kamikozuru H, et al. A case of gastric cancer accompanied by disseminated carcinomatosis of the bone marrow successfully controlled by S-1 and cisplatin combination therapy. Gan To Kagaku Ryoho 2013 Nov; 40 (12): 2241-3.
[6]	Isozaki Y, Yamanishi M, Utsunomiya S, Yamaguchi S, Okita M, Matsumoto N, Nagao Y, et al. A case of disseminated carcinomatosis of bone marrow with disseminated intravascular coagulation caused by advanced colon cancer treated by mFOLFOX6. Gan To Kagaku Ryoho 2011 Oct; 38 (10): 1705-8.
[7]	Yamazaki K, Katsumura N, Ozawa N, Ogiso H, Hanai Y, Otsuji K, Toda K, et al. A case of mucinous adenocarcinoma of the sigmoid colon with disseminated carcinomatosis of the bone marrow successfully treated with FOLFOX4/bevacizumab. Gan To Kagaku Ryoho 2013 Aug; 40 (8): 1105-9.
[8]	Higashiyama A, Kudo M, Nagasako T, Kawamura N, Abiko S, Yamamoto Y, Takano M, et al. Successful chemotherapy of carcinomatosis of the bone marrow with disseminated intravascular coagulation from a rectal carcinoma found by eosinophilia. Nihon Shokakibyo Gakkai Zasshi 2011 Jul; 108 (7): 1244-51.
[9]	Yamauchi M, Okamoto Y, Doi M, Shinokazi K. mFOLFOX6 for treatment of anal canal cancer with disseminated carcinomatosis of bone marrow-a case report. To Kagaku Ryoho 2010 Nov; 37 (11): 2209-11.
[10]	Ferrand FR, Gontier E, Guymar S, Fagot T, Ceccaldi B, Malfuson JV, de Revel T. Effectiveness and safe use of modified FOLFOX6 for metastatic gastric cancer with signet ring cell components complicated by disseminated intravascular coagulation and diffuse bone marrow carcinomatosis. Onkologie 2012; 35 (3): 118-20.
[11]	Mizota A, Shitara K, Kondo C, Nomura M, Yokota T, Takahari D, Ura T, Muro K. A case of heavily pretreated rectal cancer with disseminated intravascular coagulation that improved following reintroduction of FOLFOX plus bevacizumab. Int J Clin Oncol 2011 Dec; 16 (6): 766-9.
[12]	de Gramont A, Van Cutsem E, Schmoll HJ, Tabernero J, Clarke S, Moore MJ, Cunningham D, et al. Bevacizumab plus oxaliplatin-based chemotherapy as adjuvant treatment for colon cancer (AVANT): a phase 3 randomized controlled trial. Lancet Oncol 2012 Dec; 13 (12): 1225-33.
[13]	Yoshida Y, Hoshino S, Shiwaku H, Beppu R, Tanimura S, Tanaka S, Yamashita Y. Early start of chemotherapy after resection of primary colon cancer with synchronous multiple liver metastases: a case report. Case Rep Oncol 2011; 4: 250-254.