Disseminated carcinomatosis of the bone marrow with disseminated intravascular coagulation as the first symptom of recurrent rectal cancer successfully treated with chemotherapy: A case report and review of the literature

Takeyama,Hiroshi; Sakiyama,Tsutomu; Wakasa,Tomoko; Kitani,Kotaro; Inoue,Keisuke; Kato,Hiroaki; Ueda,Shinya; Tsujie,Masanori; Fujiwara,Yoshinori; Yukawa,Masao; Ohta,Yoshio; Inoue,Masatoshi

doi:10.3892/ol.2017.5983

Disseminated carcinomatosis of the bone marrow with disseminated intravascular coagulation as the first symptom of recurrent rectal cancer successfully treated with chemotherapy: A case report and review of the literature

Authors:
- Hiroshi Takeyama
- Tsutomu Sakiyama
- Tomoko Wakasa
- Kotaro Kitani
- Keisuke Inoue
- Hiroaki Kato
- Shinya Ueda
- Masanori Tsujie
- Yoshinori Fujiwara
- Masao Yukawa
- Yoshio Ohta
- Masatoshi Inoue
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Affiliations: Department of Gastroenterological Surgery, Nara Hospital, Faculty of Medicine, Kinki University, Nara 630‑0293, Japan, Department of Medical Oncology, Nara Hospital, Faculty of Medicine, Kinki University, Nara 630‑0293, Japan, Department of Pathology, Nara Hospital, Faculty of Medicine, Kinki University, Nara 630‑0293, Japan
Published online on: April 4, 2017 https://doi.org/10.3892/ol.2017.5983
Pages: 4290-4294
Copyright: © Takeyama et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Disseminated carcinomatosis of the bone marrow (DCBM) is a condition in which bone marrow (BM) metastases diffusely invade the BM, and is frequently accompanied by disseminated intravascular coagulation (DIC). While prostate, lung, breast and stomach malignancies, in addition to neuroblastoma, are the most prevalent non‑hematological malignancies to metastasize frequently to the BM, colorectal cancer is a malignancy that rarely metastasizes to the BM. The present case describes a 65‑year‑old male patient treated by resection and one course adjuvant chemotherapy for stage IIIC rectal cancer who presented with nasal bleeding at 8 months post‑surgery. A blood test exhibited DIC. A BM biopsy was performed and the definitive diagnosis was DCBM with DIC. Promptly, anti‑DIC treatment and chemotherapy with a modified FOLFOX6 (folinic acid, leucovorin (LV), 5‑fluorouracil (5‑FU) and oxaplatin) regimen was started. Following 1 cycle of chemotherapy, DIC was improved and subsequent to 2 cycles of modified FOLFOX6 the patient was discharged. The patient was alive 263 days subsequent to the diagnosis of DIC, but succumbed to carcinomatous meningitis as a result of disease progression. To the best of our knowledge, this is the first report of DCBM with DIC of curatively resected rectal cancer as the first presentation of relapse that was successfully treated with aggressive therapy, including chemotherapy.

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