Anemia and Leukopenia Provided an Opportunity to Diagnose Prostate Cancer with Carcinomatosis of the Bone Marrow
Shibahara, H.; Hashimoto, Y.; Takagi, Y.; Narita, M.
Gan to Kagaku Ryoho. Cancer and ChemoTherapy 46(3): 479-483
2019
ISSN/ISBN: 0385-0684 PMID: 30914589 Document Number: 698521
This paper presents the case of an 84-year-old man who was referred to the clinic because of decreased appetite and weight loss. He was diagnosed with anemia and white blood cell count reduction by a local doctor. In consideration of blood diseases, he was referred to the hospital to the department of hematology, and laboratory tests revealed a white blood cell count of 4,400/mL, hemoglobin level of 8.0 g/dL, platelet count of 12,800/mL, and high PSA level of 12.895 ng/mL. Cancer cells were found in the bone marrow biopsy and tested negative on PSA immunostaining. PET-CT revealed increased accumulation of FDG in the whole bone marrow. A biopsy of the prostate showed poorly differentiated adenocarcinoma with a Gleason score of 5+5=10 and weakly positive PSA immunostaining. Prostate cancer with carcinomatosis of the bone marrow was diagnosed. He underwent bicalutamide and degarelix treatment. He was alive 12 months after his first visit.