Abstract
The patient was a 73-year-old man in whom lower gastrointestinal endoscopy revealed a semicircular type 3 tumor in the Ra region of the rectum. A biopsy confirmed a diagnosis of signet-ring cell carcinoma. Laparoscopic low anterior resection with D3 lymphadenectomy was performed for rectal cancer classified as cT3N1bM0, cStage IIIb. Postoperative pathological staging was pT3N2aM0, pStage IIIc, and the patient received 12 courses of adjuvant chemotherapy with mFOLFOX6. He remained recurrence-free for 15 months postoperatively, but was hospitalized for acute-onset lower back pain and disseminated intravascular coagulation (DIC). MRI and bone scintigraphy confirmed multiple bone metastases from recurrent rectal cancer, leading to a diagnosis of disseminated carcinomatosis of the bone marrow. Despite initiation of treatment for DIC, his general condition did not improve and the patient died from circulatory failure on the 46th day of hospitalization. Disseminated carcinomatosis of the bone marrow due to rectal cancer is rare and has an extremely poor prognosis. While some cases achieve survival with chemotherapy, most patients present with a poor general condition at diagnosis, necessitating individualized treatment strategies.
