A Case of Malignant Melanoma Complicated by Disseminated Carcinomatosis of the Bone Marrow

Abstract

Bone metastases diffusely invading the bone marrow infrequently manifest a rapid course. The prognosis is very poor and is complicated by hematologic disorders such as DIC (disseminated intravascularcoagulation) and MAHA (microangiopathic hemolytic anemia). This condition is often caused by metastases from adenocarcinomas of the stomach and is called disseminated carcinomatosis of the bone marrow. We report a rare case of malignant melanoma complicated by disseminated carcinomatosis of the bone marrow. A 50-year-old Japanese female had an acral lentigenous melanoma on her right sole and a palpable regional lymph node. One month after an operation, she developed rapidly progressing anemia, DIC, and leukoerythroblastosis. A bone marrow biopsy showed diffuse replacemant of the marrow by melanoma cells and involvement of the intraluminal spaces of bone marrow sinusoids. Despite chemotherapy with DTIC, supportive therapy with gabexate mesilate, and transfusions of erythrocytes and platelets, she died five months after first visit.