[Disseminated bone marrow metastases from gastric cancer: detection and monitoring the effectiveness of chemotherapy by bone marrow scintigraphy].
Disseminated bone marrow metastasis of cancer is a critical condition, frequently complicated by disseminated intravascular coagulation (DIC). A 32-year-old man with gastric cancer was diagnosed as having disseminated bone marrow metastases. Bone scintigraphy demonstrated many abnormal radionuclide accumulations in the whole body. Bone marrow aspiration revealed cancer cells. Bone marrow scintigraphy with 111In-Cl3 demonstrated central marrow failure and peripheral expansion. The remission of DIC was observed after sequential methotrexate and 5-FU therapy, then uptake of radionuclide in the central bone marrow was remarkably improved by bone marrow scan. After thirteen anti-cancer chemotherapies, recurrence of DIC was suspected because of the reduction of blood platelet count. Nevertheless, repeated bone marrow scan still demonstrated the central bone marrow clearly. The patient discharged from our hospital without the recurrence of DIC. We considered bone marrow scintigraphy is useful in the detection of disseminated bone marrow metastases of cancer and monitoring the effectiveness of chemotherapy.
Imai
Y
Y
Third Department of Internal Medicine, Saitama Medical School.
Asakura
Y
Y
Kinoshita
M
M
Sueyoshi
T
T
Eguchi
Y
Y
Oota
S
S
Fujiwara
K
K
Suzuki
K
K
Miyamae
T
T
D000328:Adult; D001853:Bone Marrow / Q000000981:diagnostic imaging*; D019046:Bone Marrow Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D018279:Carcinoma, Signet Ring Cell / Q000556:secondary*; D004211:Disseminated Intravascular Coagulation / Q000150:complications; D006801:Humans; D007204:Indium; D007205:Indium Radioisotopes; D008297:Male; D011877:Radionuclide Imaging; D013274:Stomach Neoplasms / Q000473:pathology*
D007205:Indium Radioisotopes; D007204:Indium; C020758:indium trichloride