Report of a Patient of Rectal Cancer with Disseminated Carcinomatosis of the Bone Marrow who Showed Survival of 1 Year 8 Months after Successful Chemotherapy

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 79; no. 1; pp. 118 - 123
• Main Authors: MORI, Soichiro, SAKATA, Kazuya, OTA, Hirohumi, TAKIUCHI, Daisuke, MORIMOTO, Osakuni, SHIBATA, Kunitaka
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2018
• Subjects: chemotherapy; disseminated carcinomatosis of the bone marrow; rectal cancer
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.79.118

The patient was a 66-year-old male, who visited us with the chief complaint of loose stools. Colonoscopy revealed rectal cancer extending from the upper to the lower rectum, which was diagnosed by histopathology as a poorly differentiated adenocarcinoma. CT revealed swelling of the para-aortic lymph nodes and PET-CT revealed multiple bone metastases. Chemotherapy was planned for the Stage IV rectal cancer, however, laboratory examination performed 3 weeks after the patient's initial visit revealed a significantly decreased platelet count and increase of the PT-INR and serum D-Dimer levels. We made the diagnosis of disseminated carcinomatosis of the bone marrow arising from the rectal cancer, and immediately initiated the patient on chemotherapy with mFOLFOX6, along with treatment for the DIC. After the start of chemotherapy, the DIC promptly improved. The patient received until 4th line chemotherapy, and eventually died of the rectal cancer about 20 months after the start of chemotherapy. Although disseminated carcinomatosis of the bone marrow is reported to be associated with a poor prognosis, in our case, the prompt and rapid treatment may have contributed to the long-term survival of the patient.