Myelophthisic Anemia in a Patient with Lobular Breast Carcinoma Metastasized to the Bone Marrow (original) (raw)
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Case Reports in Oncology, 2021
Cancer-related microangiopathic hemolytic anemia (MAHA) is a rare and life-threatening condition. We present a patient who had been treated for invasive lobular breast carcinoma in clinical remission with fever and hemolytic anemia. The peripheral blood film showed MAHA and thrombocytopenia, and a functional deficiency of ADAMTS13 activity of 23% consistent with acquired thrombotic thrombocytopenic purpura. Bone marrow aspirate and trephine biopsy confirmed metastatic carcinoma. Further evaluation revealed the involvement of multiple bone sites without recurrence of the primary tumor. The patient received a daily plasma exchange with cryosupernatant and was pulsed with corticosteroids. MAHA related to breast cancer appears to be a rare occurrence.
Indian Journal of Medical Sciences, 2017
Carcinocythemia, the presence of circulating cancer cells in the peripheral blood is a rare event which occurs as a late manifestation of solid malignancies and can be confused as acute leukemia. A 50-year-old male with breast carcinoma presented to the hospital with complaints of breathlessness and weakness. His routine hemogram showed leucocytosis along with marked anemia and thrombocytopenia. The peripheral blood smear showed presence of blast like cells and a diagnosis of acute leukemia/metastatic carcinoma breast was considered. The blasts like cells were negative for myeloperoxidase stain. The bone marrow revealed presence of metastatic adenocarcinoma. Carcinocythemia was diagnosed and the patient has been planned for docetaxol and carboplatin based chemotherapy. The differential diagnosis for carcinocythemia is acute leukemia which is common following chemotherapy and radiotherapy for solid tumors. These patients generally have a poor prognosis and survival.
An unusual case of Essential Thrombocythemia in coexistence with Breast cancer
Bangladesh Journal of Medical Science, 2022
Essential thrombocythemia (ET) is an extremely rare myeloproliferative neoplasm (MPN) which is characterized by persistent, non-reactive thrombocytosis (> 450 X 109/L) and an increased risk for thrombotic events.These patients have an increased risk of both hematological and non-hematological malignancies however the risk of breast cancer in MPN is not increased in comparison to general population. We hereby present an extremely unusual case of ET in a 38 years old female (diagnosed with breast cancer), which came to light on routine pre-surgical work up of the patient.Diagnosis was confirmed on bone marrow aspiration clubbed with JAK 2 mutation. Patients with ET have an increased risk of thrombosis thereby it becomes challenging for the clinician to operate on a coexistent solid tumor. On extensive literary search, there was a single case of coexistent Breast Cancer and Essential Thrombocythemia and we are reporting second such coexistence to the best of our knowledge. Banglades...
Breast Cancer Research
Background Cancer-related microangiopathic haemolytic anaemia (MAHA) is a rare but life-threatening paraneoplastic syndrome. Only single cases or small series have been reported to date. We set up a retrospective multicentre study focusing on breast cancer-related MAHA. Methods Main inclusion criteria were known diagnosis of breast cancer, presence of schistocytes and either low haptoglobin or cytopenia and absence of any causes of MAHA other than breast cancer, including gemcitabine- or bevacizumab-based treatment. Patient characteristics, treatments and outcome were retrieved from digital medical records. Results Individual data from 54 patients with breast cancer-related MAHA were obtained from 7 centres. Twenty-three (44%) patients had a breast tumour with lobular features, and most primary tumours were low grade (grade I/II, N = 39, 75%). ER+/HER2−, HER2+ and triple-negative phenotypes accounted for N = 33 (69%), N = 7 (15%) and N = 8 (17%) cases, respectively. All patients had...
Transfusion Requirement in Anemia observed in Patients with Carcinoma Breast undergoing Chemotherapy
International Journal of Contemporary Medical Research [IJCMR], 2019
Introduction: Carcinoma Breast is the second most common malignancyaffecting women. Adjuvant chemotherapy is the mainstay treatment modality along with surgery. Anemia and thrombocytopenia are the hematological complications in patients with breast cancer who undergo chemotherapy. This study was carried out with an objective to identify the proportion of anemia and the requirement of Packed Red Cells transfusions in these patients. Material and methods: This is ahospital based prospective study, done for a period of one and a half years from January 2016 to June 2017.As per the inclusion criteria125 consecutive cases who underwent chemotherapy for Carcinoma Breast at Department of Radiotherapy, Govt. Medical College, Thiruvananthapuram were included for the study. The requirement of Packed Red Cell (PRC) was assessed in these patients. Data was analysed with SPSS software (version 21). Results: Among the 125 patients, 60% of patients were anemic in prechemotherapyphase with a preponderance of mild anemia,haemoglobin (Hb) 11-11.9gm/dl (as per the WHO classification of anemia in non pregnant females). Inpost chemotherapy phase the prevalence of anemia was 94.4% withincreasing severity; majority (56%) of patients had moderate anemia (Hb 8-10.9gm/dl). During chemotherapy, 22.4% of the study population required PRC transfusion. Conclusion: Due to the high prevalence of chemotherapyinduced anemia and itseffects on quality of life (QOL), even mild degrees of anemia should be detected and evaluated before commencing chemotherapy. PRC transfusion should be reserved for patients with severe anemia.
Multidisciplinary approach to anemia
Romanian Journal of Military Medicine, 2015
Introduction: We present the case of a 65 years-old woman who was admitted with a severe macrocytic anemia Hb= 5.7g/dl and diffuse bone pain. Biologically she has moderate thrombocytopenia 35 000/µl, a hepatic cytolysis and cholestatic syndrome. Material and method: The patient was extensively evaluated before presentation for a mild irondeficiency anemia for which she underwent endoscopic examination of the upper and lower gastrointestinal tract-normal. The bone marrow aspiration on admission revealed a marked hyperplasia of the erythroblastic line with ~50% basophilic erythroblasts suggesting a regenerative erythroid hyperplasia. These changes along with the marked reticulocytosis on the peripheral blood smear oriented us towards a hemolytic anemia; Folic acid, vitamin B12, autoimmune tests and hemolytic tests were all normal. We continued the investigations with a thoraco-abdominopelvic computed tomography which identified diffuse demineralization, vertebral compactation and pelvic stress fractures. The breast examination revealed a right breast nodule, but the breast ultrasonography pleaded for benignity. Lacking a clear definitive diagnosis we decided to perform a bone marrow biopsy. Results: The osteo-medullary biopsy pointed towards a medullar invasion from a lobular mammary carcinoma; In these circumstances we performed an ultrasound guided biopsy of the right mammary lump thus histologically confirming a tumoral invasion of the bone marrow with subsequent anemia. The patient started chemotherapy in the Oncology ward. Conclusion: The particularity of this case consists in the pattern of anemia, which initially seemed iron deficient and afterwards macrocytic-apparently hemolytic and was actually due to the tumoral medullar invasion and also the nonspecific ultrasonographic appearance of the breast tumor.
Pancytopenia: A Rare and Unusual Initial Presentation of Breast Cancer
Cureus, 2019
Bone marrow metastasis with profound pancytopenia is an extremely uncommon presentation of breast cancer. Advanced breast cancer can frequently metastasize to bone marrow, but bone marrow failure is not typically seen. Very limited data exist regarding the appropriate management of patients with metastatic breast cancer with profound pancytopenia. Our patient's initial presentation of anemia and thrombocytopenia was a diagnostic dilemma, later confirmed as metastatic breast cancer on bone marrow biopsy. After diagnosis, treatment was another challenge as there are no predefined treatment guidelines for these patients. After the initial hormonal therapy failed, our patient showed a good clinical response to chemotherapy and her platelet count improved to baseline. This dramatic response to chemotherapy is rare. Therefore, this case represents a rare instance of a diagnostic and therapeutic dilemma with unusual clinical response to chemotherapy.
Frequency of Chemotherapy Induced Anemia in Breast Cancer Patients
Iranian Journal of Cancer Prevention, 2016
Background: Breast cancer is the second most common malignancy in women, worldwide. Several etiologic factors may cause anemia in a patient with breast cancer. Anemia is a prevalent complication in patients with breast cancer who undergo chemotherapy which affects the health status and quality of life in these patients. The aim of this study was to evaluate the prevalence of anemia in patients with non-metastatic breast cancer who underwent adjuvant chemotherapy. Methods: In this cross-sectional study, 144 women with non-metastatic breast cancer who referred to radiotherapy and oncology department of Imam Reza hospital and met inclusion criteria were included. Data were obtained from patients' archived documents and were analyzed by SPSS software (version16). Results: In this study, 41% of patients were anemic before the chemotherapy and 43.1% of patients became anemic during and after treatment. The prevalence of post-chemotherapy anemia was significantly higher in advanced stages of cancer (P = 0.01). The chance of developing anemia were more in patients who underwent 8 cycles and AC + paclitaxel regimen, compared to the ones with 6 cycles and other regimens. There was no significant relationship between the prevalence of anemia and type of chemotherapy regimen, number of chemotherapy cycles, positive lymph nodes, co-morbidities, menstrual status, and body mass index (BMI). Conclusions: Due to the high prevalence of chemotherapy-induced anemia and its effects on quality of life, even mild degrees of anemia should be detected and evaluated before treatment. Considering early interventions is of cardinal importance, especially in the elderly.
BMJ Case Reports, 2018
We report a 48-year-old woman with metastatic infiltrating lobular carcinoma of the breast. Though her metastatic disease remained stable, she was repeatedly admitted for symptomatic anaemia and treated by red blood cell and platelet transfusions with increasing frequency as time elapsed. Abdominal examination and ultrasound revealed splenomegaly (27 cm span). A bone marrow biopsy showed fibrosis and foci of metastatic carcinoma. Splenectomy ameliorated her transfusion-dependent anaemia and thrombocytopaenia. Histopathology revealed multiple foci of metastatic carcinoma and scattered foci of extramedullary haematopoiesis. Differential diagnosis of anaemia and thrombocytopaenia in patients with cancer include bone morrow involvement by cancer cells, iron-deficiency anaemia, microangiopathies and chemotherapy suppression of haematopoiesis. Splenic involvement with cancer is common in patients with multivisceral disease. Many may regard transfusion-dependent severe anaemia and thromboc...