Diffuse osteosclerosis as a presentation of recurrent breast cancer: role of endothelin 1

• Published in: Osteoporosis international Vol. 30; no. 8; pp. 1699 - 1703
• Main Authors: Zarnecki, K. G., Kristianto, J., Charlson, J., Wilson, B., Blank, R. D., Shaker, J. L.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.08.2019; Springer Nature B.V
• Subjects: Adenocarcinoma - diagnostic imaging; Adenocarcinoma - metabolism; Adenocarcinoma - secondary; Adenocarcinoma - therapy; Autopsy; Biopsy; Bone cancer; Bone growth; Bone marrow; Bone Neoplasms - complications; Bone Neoplasms - diagnostic imaging; Bone Neoplasms - metabolism; Bone Neoplasms - secondary; Breast cancer; Breast Neoplasms - metabolism; Case Report; Endocrinology; Endothelin 1; Endothelin-1 - physiology; Endothelins; Fatal Outcome; Female; Hormone replacement therapy; Humans; Immunohistochemistry; Medicine; Medicine & Public Health; Metastases; Metastasis; Middle Aged; Orthopedics; Osteogenesis; Osteosclerosis; Osteosclerosis - diagnostic imaging; Osteosclerosis - etiology; Osteosclerosis - metabolism; Pain; Paracrine signalling; Radiography; Rheumatology; Skin diseases; Skin Neoplasms - metabolism; Skin Neoplasms - secondary; Vertebrae; Osteosclerosis; Breast cancer; Endothelin 1; Bone metastases
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-019-04998-5

Summary We report a 46-yr-old woman with a history of breast cancer who presented with diffuse myalgias, bone pain, and osteosclerosis. She was found to have recurrent breast cancer producing endothelin-1. Introduction Acquired osteosclerosis can be caused by various disorders. Endothelin -1 is believed to contribute to osteosclerosis caused by breast cancer. Methods Although the bone marrow biopsy did not reveal breast cancer, she developed skin lesions consistent with metastatic breast cancer. She ultimately died from progressive disease. At autopsy immunohistochemistry for endothelin-1 was performed on a section from the L5 vertebral body. Results The section from the L5 vertebral body showed small foci of cells consistent with metastatic carcinoma and a prominent sclerotic response. Immunohistochemistry for endothelin-1 was strongly positive. Conclusions Recurrent breast cancer may present with diffuse osteosclerosis. Endothelin-1 may be a paracrine factor responsible for increased bone formation and osteosclerosis.