Clinicopathological characteristics of disseminated carcinomatosis of the bone marrow in breast cancer patients

Shinden, Yoshiaki; Sugimachi, Keizō; Tanaka, Fumiaki; Fujiyoshi, Kenji; Kijima, Yuko; Natsugoe, Shoji; Mimori, Koshi

doi:10.3892/mco.2017.1502

Cited by 10 publications

(16 citation statements)

References 31 publications

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“…Treatment of patients with DCBM is challenging because of cytopenia. Systemic chemotherapy is generally used and recommended for DCBM in breast cancer [8,12,13]. However, chemotherapy can lead to the exacerbation of pretreatment hematologic disorders from DCBM and thus the need for supportive therapy including blood transfusion and granulocyte colony-stimulating factor support.…”

Section: Discussionmentioning

confidence: 99%

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Disseminated Carcinomatosis of the Bone Marrow from Occult Breast Cancer Responding to a Sequence of Endocrine Therapy

et al. 2020

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Patients with cancer of unknown primary (CUP) are generally treated with chemotherapy. Bone marrow involvement suggests an advanced stage, and CUP with disseminated carcinomatosis of the bone marrow (DCBM) appears to have a dismal prognosis. However, our case of CUP with DCBM was successfully treated with a sequence of endocrine therapy over a long period. A woman presenting with low back pain was found to have multiple bone metastasis without an identifiable primary tumor on imaging studies. Blood tests revealed anemia and thrombocytopenia. A bone marrow biopsy was performed and showed relatively uniform small cells, strongly positive for estrogen receptor and progesterone receptor expression. We considered chemotherapy to be risky due to bicytopenia and an aromatase inhibitor, letrozole, was initiated. The patient's symptoms and laboratory findings gradually improved and bone lesions almost disappeared on FDG-PET/CT after 1 year of treatment. After 2 years on letrozole, hemoglobin levels and platelet counts had been gradually decreasing. Although she had no symptoms and no significant changes were observed on a CT scan, disease progression was highly likely. Thus, second-line treatment with fulvestrant and palbociclib was commenced, and hemoglobin levels and platelet counts were restored to within the normal ranges. She currently continues to receive fulvestrant and palbociclib over a year later. CUP complicated with DCBM might be metastatic occult breast cancer, and endocrine therapy can be a valuable treatment option if tumors express hormone receptors.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies showed that DCBM in breast cancer is usually observed in HR-positive tumors [8,12,13]. When patients present with DCBM but without an identifiable primary site, staining IHC panels for breast cancer should be considered.…”

Section: Discussionmentioning

confidence: 99%

Disseminated Carcinomatosis of the Bone Marrow from Occult Breast Cancer Responding to a Sequence of Endocrine Therapy

et al. 2020

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“…DCBM usually arises in patients with stomach, lung and prostate cancers. 7 According to Uruga's largest clinical analysis, bone or bone marrow metastasis was found in 70% (21/30) of patients with PTTM. 2 It is interesting to note that PTTM and DCBM have many points in common: primary carcinoma site, hematological disorders, bone metastasis.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary tumor thrombotic microangiopathy associated with extramammary Paget's disease: An autopsy case report

Oyama

Nishida

Kondo

et al. 2020

Pathology International

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Pulmonary tumor thrombotic microangiopathy (PTTM) is histologically characterized by micro tumor cell embolism and intimal fibrocellular proliferation of pulmonary arteries or arterioles. We report a secondary case of PTTM associated with extramammary Paget's disease (EMPD). The patient was a 72‐year‐old man with exertional dyspnea. Clinical examinations found he had pulmonary hypertension and multiple osteolytic lesions of vertebra. Cytological analysis of pulmonary wedge artery sample detected malignant cells and he was dead before treatment was started. Multiple tumor embolisms (>17) were identified in pulmonary arteries or arterioles at autopsy, consistent with PTTM. Metastatic nodules were found in liver and lymph node. Furthermore, disseminated carcinomatosis of the bone marrow (DCBM) was seen. Immunostaining results pointed out that tumor cells possessed mammary gland phenotype. He had 4‐years history of EMPD in the left axilla without recurrence, and immunohistochemistry results were the same as the autopsy specimen. Thus, we diagnosed the primary site of PTTM to be EMPD. Our case highlights the usefulness of the recent proposed classification of PTTM, potential association between PTTM and DCBM, and the necessity for long‐term follow‐up in EMPD. EMPD can rarely cause PTTM to manifest as a paraneoplastic syndrome.

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“…We decided to evaluate the total blood count since hematological tests are part of protocols for oncological conditions to observe tumor progression and possible complications (22,23). Furthermore, studies show that tumor progression occurs by procedures related to blood cells resulting in changes to their reference levels (24)(25)(26).…”

Section: Discussionmentioning

confidence: 99%

Safety and Clinical Impact of a Single Red Light Irradiation on Breast Tumor‐Bearing Mice

Pereira

Silva

Núñez

et al. 2020

Photochem & Photobiology

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Low‐level light therapy has been used in health care as a therapeutic strategy for different diseases. However, its effects on cancer are controversial. This work evaluated the effects of three energies on breast cancer‐bearing mice after a single red light‐emitting diode (LED) irradiation. 4T1 cells were inoculated into the mammary fat pad of female BALB/c mice. When tumor volume reached 100 mm3, animals were irradiated by a LED irradiator (660 ± 11 nm) with energies of 1.2, 3.6, and 6.0 J. Control without irradiation and healthy animals were also evaluated. Mice were monitored regarding tumor volume and total blood count. After euthanasia, their organs were examined. We observed that a single irradiation does not increase tumor volume. All irradiated groups exhibited better clinical conditions than control, which presented a significant decrease in platelet and red blood cell levels compared with healthy mice. The energy of 3.6 J arrested neutrophil‐lymphocyte rate besides promoting longer survival and a lower number of metastatic nodules in the lungs. These findings suggest that a single red LED irradiation causes no impact on the course of the disease. Besides, the intermediary dose‐effect should be further investigated since it seems to promote better outcomes on breast cancer‐bearing mice.

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Clinicopathological characteristics of disseminated carcinomatosis of the bone marrow in breast cancer patients

Cited by 10 publications

References 31 publications

Disseminated Carcinomatosis of the Bone Marrow from Occult Breast Cancer Responding to a Sequence of Endocrine Therapy

Disseminated Carcinomatosis of the Bone Marrow from Occult Breast Cancer Responding to a Sequence of Endocrine Therapy

Pulmonary tumor thrombotic microangiopathy associated with extramammary Paget's disease: An autopsy case report

Safety and Clinical Impact of a Single Red Light Irradiation on Breast Tumor‐Bearing Mice

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