Disseminated Carcinomatosis of Bone Marrow as the Initial Presentation of Intrahepatic Cholangiocarcinoma without Jaundice: An Autopsy Case Report

Intern Med. 2022 Mar 1;61(5):657-662. doi: 10.2169/internalmedicine.7688-21. Epub 2021 Sep 4.

Abstract

Disseminated carcinomatosis of the bone marrow (DCBM) is often accompanied by disseminated intravascular coagulation (DIC) and has a poor prognosis. DCBM develops most frequently in gastric cancer and is rarely associated with intrahepatic cholangiocarcinoma. A 41-year-old man was incidentally found to have DIC on his regular visit for ulcerative colitis and was diagnosed with DCBM with intrahepatic cholangiocarcinoma. He received intensive care, including chemotherapy, but died suddenly from hyperkalemia, possibly due to tumor lysis syndrome (TLS). The autopsy showed the periductal infiltrating type of intrahepatic cholangiocarcinoma and tumor necrosis, possibly due to chemotherapy, indicating the effectiveness of chemotherapy for DCBM with intrahepatic cholangiocarcinoma.

Keywords: disseminated carcinomatosis of the bone marrrow; disseminated intravascular coagulation; intrahepatic cholangiocarcinoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Autopsy
  • Bile Duct Neoplasms* / complications
  • Bile Duct Neoplasms* / diagnosis
  • Bile Duct Neoplasms* / drug therapy
  • Bile Ducts, Intrahepatic / pathology
  • Bone Marrow / pathology
  • Bone Marrow Neoplasms* / complications
  • Bone Marrow Neoplasms* / diagnosis
  • Cholangiocarcinoma* / complications
  • Cholangiocarcinoma* / diagnosis
  • Cholangiocarcinoma* / drug therapy
  • Disseminated Intravascular Coagulation* / drug therapy
  • Humans
  • Jaundice* / drug therapy
  • Male
  • Peritoneal Neoplasms* / complications
  • Stomach Neoplasms* / complications
  • Stomach Neoplasms* / diagnosis
  • Stomach Neoplasms* / drug therapy