Bone marrow necrosis as the only manifestation of disseminated carcinomatosis

An unusual case with thrombocytopenia and bone marrow necrosis as the only manifestation of disseminated carcinomatosis is reported. The diagnosis was first established by repeated bone marrow biopsy which revealed marked necrosis without evidence of malignancy. The patient's general condition deteriorated rapidly despite therapy with steroids. Autopsy revealed disseminated metastatic adenocarcinoma, but the primary site of the tumor was not identified. It is suggested that malignancy should always be excluded in patients who have bone marrow necrosis without an obvious cause.