Leukoerythroblastosis in castration-resistant prostate cancer: A clue to diffuse bone marrow carcinomatosis

A 66-year-old man with a previous history of advanced prostate cancer failing complete androgen blockade, docetaxel chemotherapy, denosumab, and abiraterone acetate as judged by persistent high serum levels of prostate specific antigen presented with exertional dyspnea, normocytic anemia, and thrombocytopenia. Leukoery - throblastosis was noted in his peripheral blood. Bone marrow examination disclosed diffuse bone marrow carcinomatosis from prostate cancer. Prolonged activated partial thromboplastin time, prothrombin time, and an extremely elevated serum level of Ddimer led to a diagnosis of disseminated intravascular coagulation. Magnetic resonance imaging of spine revealed extensive bone marrow involvement but bone scan showed only scanty bony metastasis. We like to call attention to the importance of prompt bone marrow examination once recognizing leukoerythroblastosis in patients with advanced prostate cancer. Survey of a possible coexistent disseminated intravascular coagulation is as well strongly recommended in this condition.

[1]  Tasuku Hiroshige,et al.  Prostate cancer with disseminated carcinomatosis of the bone marrow: Two case reports. , 2017, Molecular and clinical oncology.

[2]  J. Tosoian,et al.  Metastatic Prostate Cancer Diagnosed by Bone Marrow Aspiration in an Elderly Man Not Undergoing PSA Screening , 2017, Urology case reports.

[3]  M. Hassali,et al.  Disseminated Intravascular Coagulation and Excessive Fibrinolysis (DIC XFL) Syndrome in Prostate Cancer: A Rare Complicated Disorder. , 2017, Journal of clinical and diagnostic research : JCDR.

[4]  R. Victorino,et al.  Massive Bleeding as the First Clinical Manifestation of Metastatic Prostate Cancer due to Disseminated Intravascular Coagulation with Enhanced Fibrinolysis , 2016, Case Reports in Hematology.

[5]  P. Clézardin,et al.  Cancer Cell Colonisation in the Bone Microenvironment , 2016, International journal of molecular sciences.

[6]  J. Taverna,et al.  Prostate Cancer-Associated Disseminated Intravascular Coagulation with Excessive Fibrinolysis Treated with Degarelix , 2015, Case reports in oncological medicine.

[7]  Y. Shiozawa,et al.  Bone marrow as a metastatic niche for disseminated tumor cells from solid tumors. , 2015, BoneKEy reports.

[8]  B. John,et al.  Prostate cancer: beware of disseminated intravascular coagulation , 2015, BMJ Case Reports.

[9]  E. Mahdi,et al.  Leucoerythroblastosis and thrombocytopenia as clues to metastatic malignancy , 2014, BMJ Case Reports.

[10]  M. F. Yazdi,et al.  Search for a cause of disseminated intravascular coagulopathy resulted in finding metastatic prostate cancer , 2013, Central European journal of urology.

[11]  Tsuyoshi Takada,et al.  [Prostate cancer with disseminated carcinomatosis of bone marrow initially presenting with disseminated intravascular coagulation syndrome: a case report]. , 2012, Hinyokika kiyo. Acta urologica Japonica.

[12]  Y. Kushida,et al.  [Disseminated carcinomatosis of the bone marrow in two patients with prostate cancer]. , 2011, Nihon Hinyokika Gakkai zasshi. The japanese journal of urology.

[13]  I. Tannock,et al.  Disseminated intravascular coagulation as the presenting sign of metastatic prostate cancer. , 2006, Journal of general internal medicine.

[14]  B. Lämmle,et al.  [Severe hemorrhage, lymphocytosis and leukoerythroblastic blood picture--disseminated intravascular coagulation in metastatic prostate carcinoma and chronic lymphatic leukemia]. , 1999, Therapeutische Umschau. Revue thérapeutique.

[15]  J. Ritchie,et al.  Leukoerythroblastic anemia in metastatic prostate cancer. Clinical and prognostic significance in patients with hormone‐refractory disease , 1993, Cancer.

[16]  THE ROYAL COLLEGE OF PATHOLOGISTS OF AUSTRALIA , 1971 .