A case report of isolated bone marrow metastasis from neuroendocrine tumor of occult primary: A pathologist's perspective on this unusual presentation - A case report

Introduction: Neuroendocrine tumors (NETs) are poorly understood neoplasms that, although slow growing compared with epithelial malignancies, can behave aggressively. Bone marrow (BM) is an uncommon site of metastasis by neuroendocrine tumors (NETs), occurring in approximately 5% of the cases. Despi...

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Main Authors: Pretty Singh, Kavita Somani, K Sujatha
Format: Article
Language:English
Published: SAGE Publishing 2022-01-01
Series:Apollo Medicine
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Online Access:http://www.apollomedicine.org/article.asp?issn=0976-0016;year=2022;volume=19;issue=5;spage=18;epage=21;aulast=Singh
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author Pretty Singh
Kavita Somani
K Sujatha
author_facet Pretty Singh
Kavita Somani
K Sujatha
author_sort Pretty Singh
collection DOAJ
description Introduction: Neuroendocrine tumors (NETs) are poorly understood neoplasms that, although slow growing compared with epithelial malignancies, can behave aggressively. Bone marrow (BM) is an uncommon site of metastasis by neuroendocrine tumors (NETs), occurring in approximately 5% of the cases. Despite advanced diagnostic techniques, primary site cannot be deciphered in few patients. Case: A 46-year-old male with a recent history of myocardial infarction, rapidly worsening back pain from past two months. He was referred to us with a suspicion of multiple myeloma with multiple lytic lesions of bone. The patient underwent a BM examination, which revealed extensive infiltration of the marrow with tumor cells positive for immunohistochemical (IHC) markers of NET with high proliferation index. Thus, a diagnosis of “metastatic NET” was rendered. Conclusion: In an occult primary, a panel of IHC biomarkers are of key importance to confirm the nature and grade of the tumor. Site-specific markers may be lost in high-grade tumors. Thus, in an era of theradiagnostics, immunohistochemistry remains a tool of paramount vitality, to accurately classify these tumors, and may aide in finding the primary site of neoplasm.
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spelling doaj-art-f3ef6d3b1a3542e394839b56dfea1ca52025-01-02T13:07:32ZengSAGE PublishingApollo Medicine0976-00162213-36822022-01-01195182110.4103/am.am_72_22A case report of isolated bone marrow metastasis from neuroendocrine tumor of occult primary: A pathologist's perspective on this unusual presentation - A case reportPretty SinghKavita SomaniK SujathaIntroduction: Neuroendocrine tumors (NETs) are poorly understood neoplasms that, although slow growing compared with epithelial malignancies, can behave aggressively. Bone marrow (BM) is an uncommon site of metastasis by neuroendocrine tumors (NETs), occurring in approximately 5% of the cases. Despite advanced diagnostic techniques, primary site cannot be deciphered in few patients. Case: A 46-year-old male with a recent history of myocardial infarction, rapidly worsening back pain from past two months. He was referred to us with a suspicion of multiple myeloma with multiple lytic lesions of bone. The patient underwent a BM examination, which revealed extensive infiltration of the marrow with tumor cells positive for immunohistochemical (IHC) markers of NET with high proliferation index. Thus, a diagnosis of “metastatic NET” was rendered. Conclusion: In an occult primary, a panel of IHC biomarkers are of key importance to confirm the nature and grade of the tumor. Site-specific markers may be lost in high-grade tumors. Thus, in an era of theradiagnostics, immunohistochemistry remains a tool of paramount vitality, to accurately classify these tumors, and may aide in finding the primary site of neoplasm.http://www.apollomedicine.org/article.asp?issn=0976-0016;year=2022;volume=19;issue=5;spage=18;epage=21;aulast=Singhbone marrowimmunohistochemistrymetastasisneuroendocrine neoplasmneuroendocrine tumor
spellingShingle Pretty Singh
Kavita Somani
K Sujatha
A case report of isolated bone marrow metastasis from neuroendocrine tumor of occult primary: A pathologist's perspective on this unusual presentation - A case report
Apollo Medicine
bone marrow
immunohistochemistry
metastasis
neuroendocrine neoplasm
neuroendocrine tumor
title A case report of isolated bone marrow metastasis from neuroendocrine tumor of occult primary: A pathologist's perspective on this unusual presentation - A case report
title_full A case report of isolated bone marrow metastasis from neuroendocrine tumor of occult primary: A pathologist's perspective on this unusual presentation - A case report
title_fullStr A case report of isolated bone marrow metastasis from neuroendocrine tumor of occult primary: A pathologist's perspective on this unusual presentation - A case report
title_full_unstemmed A case report of isolated bone marrow metastasis from neuroendocrine tumor of occult primary: A pathologist's perspective on this unusual presentation - A case report
title_short A case report of isolated bone marrow metastasis from neuroendocrine tumor of occult primary: A pathologist's perspective on this unusual presentation - A case report
title_sort case report of isolated bone marrow metastasis from neuroendocrine tumor of occult primary a pathologist s perspective on this unusual presentation a case report
topic bone marrow
immunohistochemistry
metastasis
neuroendocrine neoplasm
neuroendocrine tumor
url http://www.apollomedicine.org/article.asp?issn=0976-0016;year=2022;volume=19;issue=5;spage=18;epage=21;aulast=Singh
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