Yamada Tomonori, Nakajima Junya, Ooba Yuuki, Yabuno Akira, Yano Yuri, Yoshida Masaki, Yano Mitsutake, Yasuda Masanori, Kobayashi Eiji
Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Yufu, Oita 8795593, Japan.
Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita 8795593, Japan.
Mol Clin Oncol. 2025 Jan 21;22(3):27. doi: 10.3892/mco.2025.2822. eCollection 2025 Mar.
Bone marrow metastasis (BMM) causes pancytopenia and disseminated intravascular coagulation (DIC), resulting in rapid mortality. The incidence of this disease is likely underestimated, with confirmed BMM occurring at approximately twice the rates expected clinically. The present study describes two detailed cases and includes a literature review of BMM caused by ovarian cancer. The existing medical records of patients admitted to Oita University Hospital (Yufu, Japan) and Saitama Medical University International Medical Center (Hidaka, Japan) were retrospectively analyzed and a literature review regarding BMM associated with ovarian cancer was conducted. The literature review of BMM of ovarian cancer, including the present cases, revealed that patient ages ranged between 37 and 71 years, with tumor histology described in 5 out of 8 cases. Notably, 3 previous cases involved rare histological types (small cell carcinoma, carcinosarcoma and mucinous carcinoid), whereas the present identified cases involved common types. The first case involved a patient who developed isolated BMM/carcinomatosis during maintenance therapy with olaparib for recurrent high-grade ovarian serous carcinoma. The patient initially presented with elevated cancer antigen 125 levels and decreased blood counts. Following the onset of BMM, the patient's lactate dehydrogenase level was elevated to 2,712 U/l. The second patient was diagnosed with BMM/carcinomatosis, concurrent with an initial diagnosis of ovarian clear cell carcinoma. Both patients subsequently developed pancytopenia and DIC, resulting in mortality. To the best of our knowledge, the present study is the first retrospective study of BMM of ovarian cancer. For early diagnosis, BMM should be considered in the differential diagnosis when a reduction in blood counts is accompanied by an elevation in serum tumor markers, regardless of histological type.
骨髓转移（BMM）可导致全血细胞减少和弥散性血管内凝血（DIC），从而迅速导致死亡。这种疾病的发病率可能被低估，确诊的BMM发生率约为临床预期发生率的两倍。本研究描述了两个详细病例，并对卵巢癌引起的BMM进行了文献综述。对大分大学医院（日本由布市）和埼玉医科大学国际医疗中心（日本日高市）收治患者的现有病历进行了回顾性分析，并对与卵巢癌相关的BMM进行了文献综述。包括本病例在内的卵巢癌BMM文献综述显示，患者年龄在37岁至71岁之间，8例中有5例描述了肿瘤组织学。值得注意的是，之前的3例涉及罕见的组织学类型（小细胞癌、癌肉瘤和黏液性类癌），而本研究确定的病例涉及常见类型。第一例患者在接受奥拉帕利维持治疗复发性高级别卵巢浆液性癌期间发生孤立性BMM/癌转移。患者最初表现为癌抗原125水平升高和血细胞计数下降。BMM发病后，患者的乳酸脱氢酶水平升至2712 U/l。第二例患者被诊断为BMM/癌转移，同时初诊为卵巢透明细胞癌。两名患者随后均出现全血细胞减少和DIC，最终死亡。据我们所知，本研究是第一项关于卵巢癌BMM的回顾性研究。为实现早期诊断，当血细胞计数减少伴有血清肿瘤标志物升高时，无论组织学类型如何，在鉴别诊断中均应考虑BMM。
