Diffuse peritoneal carcinomatosis with ascites and disseminated bone marrow carcinomatosis as initial presentation of occult breast cancer

2020 ◽  
Vol 26 (11) ◽  
pp. 2233-2234
Author(s):  
Anannya Patwari ◽  
Vineel Bhatlapenumarthi
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Peritoneal Carcinomatosis ◽  
Initial Presentation ◽  
Occult Breast Cancer

scholarly journals Diffuse Bone Marrow Metastasis as the Initial Presentation of an Occult Breast Cancer

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Frank S. Fan ◽  
Chung-Fan Yang ◽  
Yi-Fen Wang
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Interleukin 1 ◽  
Growth Factor Receptor ◽  
Metastatic Potential ◽  
Initial Presentation ◽  
Unknown Primary ◽  
Bone Marrow Metastasis ◽  
Mucin 1 ◽  
Occult Breast Cancer

Introduction. Breast cancer is one of the malignancies which tend to involve the bone marrow, but initial presentation with diffuse bone marrow metastasis from an occult breast cancer is very rare. Prognosis is generally very poor for marrow metastasis from solid tumors except that breast cancer is a treatable disease even in such a dismal condition. Case. A 64-year-old woman’s headache was found to result from diffuse adenocarcinoma metastasis in the bone marrow from an unknown primary site. Intensive immunohistochemistry study of bone marrow biopsy specimen confirmed the disease nature to be an estrogen receptor-positive/human epidermal growth factor receptor 2-negative breast cancer. Mammography and magnetic resonance imaging of breasts revealed a suspicious primary lesion in the right breast. Treatment with tamoxifen alone achieved a sustained response. Discussion. Mucin 1 (MUC1), also known as cancer antigen 15-3 (CA 15-3), facilitates motility and metastatic potential of breast cancer cells. Interleukin-1β (IL-1β) drives breast cancer cell growth and colonization in bone marrow adipose tissue niche. Receptor activator of nuclear factor kappa-B (RANK) and its ligand (RANKL) activate osteoclasts to make a favorable bone marrow microenvironment for tumor cells. Agents against MUC1, IL-1β, and RANKL might be of therapeutic effect for patients like ours.

scholarly journals Gastric Linitis Plastica and Peritoneal Carcinomatosis as First Manifestations of Occult Breast Carcinoma: A Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Mara Mantiero ◽  
Giovanni Faggioni ◽  
Alice Menichetti ◽  
Matteo Fassan ◽  
Valentina Guarneri ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Peritoneal Carcinomatosis ◽  
Breast Lesion ◽  
Good Condition ◽  
Linitis Plastica ◽  
Histological Evaluation ◽  
Occult Breast Cancer ◽  
Gastric Adenocarcinomas ◽  
Occult Breast Carcinoma ◽  
Gastric Neoplasia

Gastric linitis plastica is a diffuse involvement of the stomach walls by neoplastic cells. It represents about 3–19% of primitive gastric adenocarcinomas, but it can also be the manifestation of a metastatic disease. Breast cancer is the most frequent malignancy in women, and the metastatic spread to the stomach occurs in less than 10% of the cases. We present an unusual case of gastric linitis plastica and peritoneal carcinomatosis as manifestations of an occult breast cancer in a 53-year-old woman. Imaging and endoscopic evaluation were not able to discriminate a primary from a secondary gastric lesion. The histological evaluation excluded the diagnosis of a primary gastric neoplasia. The IHC profile was consistent with the diagnosis of metastases from the breast cancer. Due to the hormonal receptors’ positivity, we started therapy with fulvestrant (500 mg, day 0, 14, and 28 and every 28 days thereafter by intramuscular injection). After 20 months, the same therapy is still ongoing and well tolerated, while the patient is in good condition with improvement of the dysphagia. Almost 2 years after the diagnosis of linitis plastica, the primitive breast lesion is still occult.

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

2020 ◽  
Vol 13 (1) ◽  
pp. 193-199 ◽  
Author(s):  
Takeshi Yamaguchi ◽  
Mariko Masumoto ◽  
Urara Sakurai ◽  
Minoru Nakane
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Endocrine Therapy ◽  
Bone Marrow Involvement ◽  
Receptor Expression ◽  
Small Cells ◽  
Bone Lesions ◽  
Occult Breast Cancer ◽  
Platelet Counts ◽  
Normal Ranges

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.

scholarly journals Anemia and thrombocytopenia as initial symptoms of occult breast cancer with bone marrow metastasis

Medicine ◽  
2017 ◽  
Vol 96 (45) ◽  
pp. e8529 ◽  
Author(s):  
Lulu Liu ◽  
Jingjing Zhang ◽  
Mingtai Chen ◽  
Saisai Ren ◽  
Haihui Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Bone Marrow Metastasis ◽  
Occult Breast Cancer ◽  
Initial Symptoms
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