open access

Vol 48, No 2 (2017)
Praca oryginalna / Original research article
Published online: 2017-04-01
Submitted: 2016-06-15
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Metastasis of solid tumors into bone marrow – Single center experience

Anna Kołda1, Grzegorz Helbig1, Anna Kopińska1, Ryszard Wichary1, Jacek Pająk2, Sławomira Kyrcz-Krzemień2
DOI: 10.1016/j.achaem.2017.05.001
·
Acta Haematol Pol 2017;48(2):130-134.
Affiliations
  1. Research Student's Group, School of Medicine in Katowice, Silesian Medical University, Department of Hematology and Bone Marrow Transplantation, Katowice, Poland
  2. School of Medicine in Katowice, Silesian Medical University, Department of Pathology, Katowice, Poland

open access

Vol 48, No 2 (2017)
Praca oryginalna / Original research article
Published online: 2017-04-01
Submitted: 2016-06-15

Abstract

Introduction: Metastases of solid tumors to the bone marrow are rarely reported. Clinical manifestation and laboratory findings remain uncharacteristic and lead to misdiagnosis. Detection of bone marrow metastases may have an impact on therapeutic decisions and is usually associated with poor prognosis. Aim: To characterize clinical picture and hematological findings in patients with bone marrow metastasis. Material and methods: We retrospectively reviewed medical records of patients with bone marrow metastases who were primary misdiagnosed with hematological malignancies. Results: Ten patients at median age of 51 years at diagnosis were included. There were following findings on admission: duopenia (n=7), pancytopenia (n=1), anemia (n=1) and skeletal lytic lesions (n=1). The diagnosis of prior cancer was reported in 3 patients and included multiple myeloma, breast cancer and oligoastrocytoma. Clinical manifestations were hepatomegaly (n=4), lymphadenopathy (n=4), skin pallor (n=3), cachexia (n=2) and hemorrhagic diathesis (n=2). Imaging studies revealed diffuse bone lesions (n=5), pulmonary infiltrates (n=2) and liver masses (n=2). Leukoerythroblastosis was demonstrated in 4 cases. Bone marrow aspirate detected the presence of abnormal cell population in 4 patients. In all studied patients a final diagnosis was established by immunohistochemistry of bone marrow biopsy. The following malignancies were detected: prostate adenocarcinoma (n=2), anaplastic microcellular carcinoma of unknown origin (n=2), adenocarcinoma of unknown origin (n=2), Ewing's sarcoma (n=1), breast cancer (n=1), clarocellular renal cancer (n=1) and neuroendocrine tumor (n=1). Nine out of the 10 metastatic patients died shortly after chemotherapy. Conclusions: Unexplained hematological abnormalities should arise the suspicion of bone marrow metastases.

Abstract

Introduction: Metastases of solid tumors to the bone marrow are rarely reported. Clinical manifestation and laboratory findings remain uncharacteristic and lead to misdiagnosis. Detection of bone marrow metastases may have an impact on therapeutic decisions and is usually associated with poor prognosis. Aim: To characterize clinical picture and hematological findings in patients with bone marrow metastasis. Material and methods: We retrospectively reviewed medical records of patients with bone marrow metastases who were primary misdiagnosed with hematological malignancies. Results: Ten patients at median age of 51 years at diagnosis were included. There were following findings on admission: duopenia (n=7), pancytopenia (n=1), anemia (n=1) and skeletal lytic lesions (n=1). The diagnosis of prior cancer was reported in 3 patients and included multiple myeloma, breast cancer and oligoastrocytoma. Clinical manifestations were hepatomegaly (n=4), lymphadenopathy (n=4), skin pallor (n=3), cachexia (n=2) and hemorrhagic diathesis (n=2). Imaging studies revealed diffuse bone lesions (n=5), pulmonary infiltrates (n=2) and liver masses (n=2). Leukoerythroblastosis was demonstrated in 4 cases. Bone marrow aspirate detected the presence of abnormal cell population in 4 patients. In all studied patients a final diagnosis was established by immunohistochemistry of bone marrow biopsy. The following malignancies were detected: prostate adenocarcinoma (n=2), anaplastic microcellular carcinoma of unknown origin (n=2), adenocarcinoma of unknown origin (n=2), Ewing's sarcoma (n=1), breast cancer (n=1), clarocellular renal cancer (n=1) and neuroendocrine tumor (n=1). Nine out of the 10 metastatic patients died shortly after chemotherapy. Conclusions: Unexplained hematological abnormalities should arise the suspicion of bone marrow metastases.

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Keywords

Bone marrow; Solid tumor; Hematological malignancy; Metastasis

About this article
Title

Metastasis of solid tumors into bone marrow – Single center experience

Journal

Acta Haematologica Polonica

Issue

Vol 48, No 2 (2017)

Pages

130-134

Published online

2017-04-01

DOI

10.1016/j.achaem.2017.05.001

Bibliographic record

Acta Haematol Pol 2017;48(2):130-134.

Keywords

Bone marrow
Solid tumor
Hematological malignancy
Metastasis

Authors

Anna Kołda
Grzegorz Helbig
Anna Kopińska
Ryszard Wichary
Jacek Pająk
Sławomira Kyrcz-Krzemień

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