Prostate Cancer with Disseminated Carcinomatosis of Bone Marrow Initially Presenting with Disseminated Intravascular Coagulation Syndrome : A Case Report

摘要

A 56-year-old man was admitted to our hospital complaining of dyspnea, general fatigue and lumbago. Several examinations revealed severe pancytopenia with disseminated intravascular coagulation (DIC), multiple lymph node metastases, and extremely high serum prostate specific antigen (PSA) level. Hormonal therapyunder a diagnosis of advanced prostate cancer was started. Bone marrow biopsy, performed for the assessment of pancytopenia, revealed that there were no hematopoietic cells but only diffuse infiltration of prostate cancer cells. His bone scintigraphyshowed a super scan image. Therefore, our diagnosis was prostate cancer with disseminated carcinomatosis of bone marrow. Although the response to hormonal therapyhad been initiallygood, the time to PSA nadir was 9 weeks and he died 34 weeks after the start of the treatment. To our knowledge, 20 cases of prostate cancer with disseminated carcinomatosis of bone marrow have been reported in the Japanese literature including this case and the clinical features are reviewed.