Disseminated carcinomatosis of the bone marrow caused by granulocyte colony-stimulating factor:A case report and review of literature  

作　　者：Kengo Fujita Ayaka Okubo Toshitsugu Nakamura Nobumichi Takeuchi 

机构地区：[1]Department of Medical Oncology,Ina Central Hospital,Nagano 396-8555,Japan [2]Department of Diagnostic Pathology,Ina Central Hospital,Nagano 396-8555,Japan

出　　处：《World Journal of Gastrointestinal Oncology》2022年第10期2077-2084,共8页世界胃肠肿瘤学杂志（英文版）（电子版）

摘　　要：BACKGROUND Disseminated carcinomatosis of the bone marrow(DCBM)is a widespread metastasis with a hematologic disorder that is mainly caused by gastric cancer.Although it commonly occurs as a manifestation of recurrence long after curative treatment,the precise mechanism of relapse from dormant status remains unclear.Granulocyte colony-stimulating factor(G-CSF)can promote cancer progression and invasion in various cancers.However,the potential of G-CSF to trigger recurrence from a cured malignancy has not been reported.CASE SUMMARY A 55-year-old Japanese woman was diagnosed with Ewing sarcoma localized on the fifth lumbar vertebrae 6 years after curative gastrectomy for T1 gastric cancer.After palliative surgery to release nerve compression,pathological diagnosis of the resected specimen was followed by curative radiation and chemotherapy.During treatment,G-CSF was administered 32 times for severe neutropenia prophylaxis.Eight months after completing definitive treatment,she complained of severe back pain and was diagnosed as multiple bone metastases with DCBM from gastric cancer.Despite palliative chemotherapy,she died of disseminated intravascular coagulation 13 d after the diagnosis.Immunohistochemical examination of the autopsied bone marrow confirmed a diffuse positive staining for the G-CSF receptor(G-CSFR)in the relapsed gastric cancer cell cytoplasm,whereas the primary lesion cancer cells showed negative staining for G-CSFR.In this case,G-CSF administration may have been the key trigger for the disseminated relapse of a dormant gastric cancer.CONCLUSIONWhen administering G-CSF to cancer survivors,recurrence of a preceding cancer should be monitored even after curative treatment.

关 键 词：Disseminated bone marrow carcinomatosis Gastric cancer Granulocyte colony-stimulating factor Cancer survivor IMMUNOSTAINING Case report 

分 类 号：R733.3[医药卫生—肿瘤] R735.2[医药卫生—临床医学]