[Extensive bone marrow necrosis and thrombotic microangiopathic anemia revealing disseminated adenocarcinoma].

BACKGROUND

Bone marrow necrosis and thrombotic microangiopathy are uncommonly associated. We report an observation.

CASE REPORT: A 52-year-old man with extensive bone marrow necrosis, associated with hemolytic microangiopathic anemia, was treated unsuccessfully with corticosteroids and plasmapheresis. Outcome was fatal. Autopsy showed disseminated bone marrow necrosis and medullary invasion by adenocarcinoma cells in this patient operated 13 years earlier for gastric cancer.

DISCUSSION: Extensive bone marrow necrosis or thrombotic microangiopathy can complicate usually advanced cancer. Prognosis is poor without response to chemotherapy. Corticosteroids and plasma exchange are sometimes successful. A relative efficacy of treatment with staphylococcal protein A immunopheresis is reported by several authors in thrombotic microangiopathy.