Journal of

Case Reports and Images in Oncology

 
     
Case Report
 
Gastric adenocarcinoma with bone marrow carcinomatosis complicated with cancer related thrombotic microangiopathy: A case report
Semih Gülle1, Emin Taskiran1, Elif Gram1, Sümeyye Ekmekçi2, Zeki Sürmeli3, Harun Akar1
1Tepecik Education and Research Hospital, Internal Medicine Department, Izmir, Turkey
2Tepecik Education and Research Hospital, Pathology Department, Izmir, Turkey
3Tepecik Education and Research Hospital, Oncology Department, Izmir, Turkey

Article ID: 100039Z10SG2017
doi:10.5348/Z10-2017-39-CR-10

Address correspondence to:
Semih Gülle
Tepecik Education and Research Hospital
Internal Medicine Department Izmir
Turkey

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How to cite this article
Gülle S, Taskiran E, Gram E, Ekmekçi S, Sürmeli Z, Akar H. Gastric adenocarcinoma with bone marrow carcinomatosis complicated with cancer related thrombotic microangiopathy: A case report. J Case Rep Images Oncology 2017;3:44–47.


ABSTRACT
Introduction: Thrombotic microangiopathy is a common complication in cancer patients. Thrombotic microangiopathy occurs in association with a variety of malignancies, especially adenocarcinomas. The prognosis is not as favorable as in classical thrombotic thrombocytopenic purpura (TTP). Presentation may be either at an early stage of cancer or associated with disseminated disease.
Case Report: We report a case of a 38-year-old male affected by metastatic gastric adenocarcinoma, who first presented with thrombotic microangiopathy and melena. Esophagogastroduodenoscopy revealed advanced gastric cancer (AGC). The signet ring cell gastric cancer was diagnosed by biopsy. He was considered as cancer related thrombotic microangiopathy (CR-TMA). Despite receiving intensive therapy for CR-TMA, his clinical status worsened. Bone marrow biopsy led to a diagnosis of disseminated carcinomatosis of the bone marrow caused by AGC.
Conclusion: Cancer related thrombotic microangiopathy is a devastating complication of malignant diseases and mainly seen in late-stage metastasized carcinomas. The underlying cancers are pre-dominantly adenocarcinomas. There is increasing evidence that bone marrow infiltration, frequently seen in prostate, lung, breast, ovarian and gastric cancer, is associated with thrombotic microangiopathy. Before any form of therapy is initiated, several questions have to raised, such as whether TMA is primary or secondary to a metastatic carcinoma.

Keywords: Bone marrow carcinomatosis, Gastric cancer, Microangiopathy


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Author Contributions
Semih Gülle – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Emin Taskiran – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Elif Gram – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Sümeyye Ekmekçi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Zeki Sürmeli – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Harun Akar – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Semih Gülle et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.


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