播種性骨髄癌症で発症した前立腺癌

A case of prostatic cancer presenting as disseminated carcinomatosis of bone marrow

　64歳男性が鼻出血，腰痛，両肩痛を主訴に受診し，骨シンチグラフィーにて多発骨転移を認めた。血液検査で白赤芽球症および播種性血管内凝固症候群（DIC）をきたしており，骨髄穿刺で播種性骨髄癌症と診断した。血中前立腺特異抗原高値のため前立腺癌を疑い，前立腺生検にて確定診断した。治療開始するも4か月後に癌死した。

　A 64-year-old man was admitted to our hospital complaining of nasal bleeding,lumbago and bilateral shoulder pain. Bone scintigraphy showed massive bone metastasis. Histologic examination of bone marrow revealed diffuse infiltration of adenocarcinoma accompanied with leukoerythroblastosis and disseminated intravascular coagulation（DIC）. Serum prostate specific antigen level was high,and prostate needle biopsy revealed prostatic adenocarcinoma. Leukoerythroblastic anemia and DIC were induced by massive bone metastasis of prostatic adenocarcinoma. Inspite of transient remission of the disease,the patient died of progresion of the disease four months later.