Prostate cancer with disseminated carcinomatosis of the bone marrow: Two case reports

Disseminated carcinomatosis of the bone marrow (DCBM) is caused by cancer metastasis to the bone marrow and is often accompanied by disseminated intravascular coagulation (DIC), with rapid clinical progression. We herein report two cases receiving treatment with combined androgen blockade (CAB) and denosumab for prostate cancer with DCBM. The patient in case 1 was an 80-year-old man who was admitted with a 3-day history of melena and was diagnosed with prostate cancer with DCBM by bone marrow biopsy. Despite receiving therapy with CAB and denosumab, the patient developed castration-resistant prostate cancer (CRPC) with accompanying relapse of DIC and succumbed to the disease 7 months later. The patient in case 2 was a 64-year-old man who was admitted with bleeding after a tooth extraction. After a diagnosis of prostate cancer with DCBM, CAB therapy was administered. Enzalutamide was administered following development of CRPC, and the patient has not since experienced an increase in prostate-specific antigen, recurrence of anemia or DIC. To the best of our knowledge, these are the first documented cases in which DCBM was treated with denosumab and enzalutamide.