[Macrophage activation syndrome revealing colon carcinoma About a case]

Macrophage activation syndrome is a state of hyper-inflammation that results from increased secretion of proinflammatory cytokines, responsible of the inappropriate activation and proliferation of cells from the lymphohistiocyte lineage. It associates clinical signs, biological abnormalities and images of haemophagocytosis. It is a rare but serious attack, that can be "primary" or "secondary" to an infection, neoplasia, or autoimmune disease. Cancer etiology by solid tumor is exceptional. We report here a case of MAS that revealed a colon carcinoma with medullary metastasis in a 62 years old patient. MAS can complicate or reveal a solid tumor in only 1.6% of cases, especially when there is spinal metastasis. This association has rarely been reported in the literature, and only in isolated cases. Moreover, in our patient reports the metastases of colon cancer are located in the bone, which is less frequent than liver and lung metastases. MAS is a serious pathology with high mortality, associated with inappropriate activation of the immune system. Etiological treatment is necessary and may be sufficient.