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Case Reports
. 2022 Apr 22;15(1):436-441.
doi: 10.1159/000524152. eCollection 2022 Jan-Apr.

Bone Marrow Carcinomatosis in a Stage IV Breast Cancer Patient Treated by Letrozole as First-Line Endocrine Therapy

Tsuyoshi Nakagawa  1 , Kumiko Hayashi  1 , Ayumi Ogawa  1 , Goshi Oda  1 , Iichiro Onishi  2 , Masahide Yamamoto  3 , Mio Mori  4 , Tomoyuki Fujioka  4 , Toshiaki Ishikawa  5 , Kentaro Okamoto  5 , Hiroyuki Uetake  5
Affiliations
Case Reports

Bone Marrow Carcinomatosis in a Stage IV Breast Cancer Patient Treated by Letrozole as First-Line Endocrine Therapy

Tsuyoshi Nakagawa et al. Case Rep Oncol. .

Abstract

Bone marrow carcinomatosis (BMC) associated with breast cancer is a rare but often difficult-to-treat condition; we report a case of a female stage IV breast cancer patient in her seventies with BMC that improved with endocrine monotherapy. The patient had hemoglobinopenia and thrombocytopenia at the time of diagnosis. The diagnosis of BMC due to estrogen receptor-positive invasive lobular carcinoma was confirmed. After transfusion of 4 units of concentrated red blood cells, endocrine treatment with letrozole improved the hematopenia. Ten months after the treatment started, bone metastases worsened, so the patient was changed to combination therapy with palbociclib and fulvestrant, after which there was no worsening of the disease.

Keywords: Bone marrow carcinomatosis; Breast cancer; Endocrine therapy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Pathological diagnosis of bone marrow puncture specimens. Magnification is ×400. H&E staining (a), E-cadherin-negative (b), AE1/3-positive (c), GATA3-positive (d), estrogen receptor-positive (e), progesterone receptor-negative (f), and HER2-negative (g).
Fig. 2
Fig. 2
Pathological diagnosis of needle biopsy specimen of breast tumor. Magnification is ×400. H&E staining (a), E-cadherin-negative (b), estrogen receptor-positive (c), progesterone receptor-negative (d), and HER2-negative (e).
Fig. 3
Fig. 3
PET-CT image. a PET-CT before the start of treatment. b PET-CT image 6 months after the treatment started, showing improvement in bone metastasis.
Fig. 4
Fig. 4
Changes in Hb and Plts during treatment. pRBC, packed red blood cells.
Fig. 5
Fig. 5
Changes in carcinoembryonic antigen levels during treatment.
See this image and copyright information in PMC

References

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