An unexpected finding of bone marrow metastasis from adenocarcinoma of lower gastrointestinal tract origin: Case report

Bone marrow examination is an essential tool for diagnosis of many diseases including both hematological and non hematological tumors. Bone marrow is commonly involved by many metastatic solid tumors. Bone marrow aspirates, and biopsies have been found to be more useful than radiological investigations in early diagnosis of bone marrow metastasis.Here we present a case of a 75 years old male patient presenting with acute sudden onset chest pain along with multiple lytic sclerotic foci in lumbar vertebrae, bilateral ribs, clavicle, scapula and sternum along with fractures in multiple ribs. CBC findings showed anemia with thrombocytopenia. Bone marrow examination revealed an infiltration of a metastatic tumor in bone marrow which was further confirmed to be of lower gastrointestinal tract in origin on IHC findings.A high suspicion for bone marrow metastasis should be considered in cases who present primarily with abnormalities in peripheral blood count and a vigilant search for metastatic cells on aspirate smears and imprint smears can help in early diagnosis of bone marrow metastasis by solid tumors.