Bone marrow metastasis of ovarian cancer: A two‑center retrospective study and literature review

Yamada,Tomonori; Nakajima,Junya; Ooba,Yuuki; Yabuno,Akira; Yano,Yuri; Yoshida,Masaki; Yano,Mitsutake; Yasuda,Masanori; Kobayashi,Eiji

doi:10.3892/mco.2025.2822

Bone marrow metastasis of ovarian cancer: A two‑center retrospective study and literature review

Authors:
- Tomonori Yamada
- Junya Nakajima
- Yuuki Ooba
- Akira Yabuno
- Yuri Yano
- Masaki Yoshida
- Mitsutake Yano
- Masanori Yasuda
- Eiji Kobayashi
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Affiliations: Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Yufu, Oita 8795593, Japan, Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, Oita 8795593, Japan, Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 3501298, Japan, Department of Medical Oncology and Hematology, Faculty of Medicine, Oita University, Yufu, Oita 8795593, Japan, Department of Diagnostic Pathology, Saitama Medical University International Medical Center, Hidaka, Saitama 3501298, Japan
Published online on: January 21, 2025 https://doi.org/10.3892/mco.2025.2822
Article Number: 27
Copyright: © Yamada et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Bone marrow metastasis (BMM) causes pancytopenia and disseminated intravascular coagulation (DIC), resulting in rapid mortality. The incidence of this disease is likely underestimated, with confirmed BMM occurring at approximately twice the rates expected clinically. The present study describes two detailed cases and includes a literature review of BMM caused by ovarian cancer. The existing medical records of patients admitted to Oita University Hospital (Yufu, Japan) and Saitama Medical University International Medical Center (Hidaka, Japan) were retrospectively analyzed and a literature review regarding BMM associated with ovarian cancer was conducted. The literature review of BMM of ovarian cancer, including the present cases, revealed that patient ages ranged between 37 and 71 years, with tumor histology described in 5 out of 8 cases. Notably, 3 previous cases involved rare histological types (small cell carcinoma, carcinosarcoma and mucinous carcinoid), whereas the present identified cases involved common types. The first case involved a patient who developed isolated BMM/carcinomatosis during maintenance therapy with olaparib for recurrent high‑grade ovarian serous carcinoma. The patient initially presented with elevated cancer antigen 125 levels and decreased blood counts. Following the onset of BMM, the patient's lactate dehydrogenase level was elevated to 2,712 U/l. The second patient was diagnosed with BMM/carcinomatosis, concurrent with an initial diagnosis of ovarian clear cell carcinoma. Both patients subsequently developed pancytopenia and DIC, resulting in mortality. To the best of our knowledge, the present study is the first retrospective study of BMM of ovarian cancer. For early diagnosis, BMM should be considered in the differential diagnosis when a reduction in blood counts is accompanied by an elevation in serum tumor markers, regardless of histological type.

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