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Archives in Cancer Research

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Case Blog - (2015) Volume 3, Issue 2

Bone Loss as Sign of Cancer Relapse

Mara Carsote1*,Anda Dumitrascu2, Adina Ghemigian1 and,Catalina Poiana1
  1. Department of Endocrinology, C.I. Parhon National Institute of Endocrinology and C.Davila University of Medicine and Pharmacy, Bucharest, Romania
  2. Department of Imagery and Radiology, C.I. Parhon National Institute of Endocrinology, Bucharest, Romania
Corresponding Author: Mara Carsote,Department of Endocrinology, C.I. Parhon National Institute of Endocrinology and C. Davila University of Medicine and Pharmacy, Bucharest, Romania,Tel: +40213172041 Fax: +40213170607 E-mail: carsote_m@hotmail.com
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Abstract

There is a tacit assumption that cancer cell lines removed from incubation and tumors that grow from the injection of these cells into mice diminish vitality quickly. When the melanoma tumors (from about 1 million B16-BL6 cells injected within 1 hr after removal from incubation) were removed about three to four weeks later and placed over the sensors of photomultiplier tubes conspicuous ~40 min periodicities of photon emissions began between 24 to 48 hr later. One million cells extracted from 10 cc suspensions of (~108) mouse melanoma cells that remained at room temperature for up to 3 days (when the smell was fetid) still produced viable tumors when injected subcutaneously. The tumors were more aqueous than those produced from immediately injected cells and were similarly fetid upon dissection unlike typical melanoma tumors. Their histopathology was qualitatively different. These results indicate that aggregates of cells in suspension or as tumors show unexpected properties that should be accommodated in models of proliferation and growth for malignant cells.

80 year old non-smoker male was operated and considered cured for 2 cancers: 16 years ago for a urinary bladder carcinoma (pT1NoMo) and 12 years ago for a non-metastatic prostate adenocarcinoma of grade II. At that time surgical castration was performed and 24 months later he developed hypogonadism related osteoporosis. Dual Energy X-Ray Absortiometry (DXA) found a femoral neck bone mineral density (BMD) of 0.63 g/ cm2, T-score of -3.3, and Z-score of -2. He was treated with oral bisphosphonates for 7 years. At that time the whole body bone scintigrame was negative for bone metastases and the abdominal computer tomography proved no tumour relapse so he continued anti-osteoporotic therapy for 2 more years. He was referred to our tertiary centre of endocrinology for lack of BMD improvement despite of anti-osteoporotic therapy (femoral neck BMD of 0.545 g/cm2, T-score of -3.7, Z-score of -1.7). On admission the bone markers were suppressed and normal parathormone and thyroid stimulating hormone levels were found. Vitamin D was inadequate based on 25-hydroxy vitamin D of 16 ng/mL (normal levels above 30 ng/mL). Computer tomography exam found multiple metasrases at the level of urinary bladder wall and left trochanter (Figure 1). Vitamin D supplements were started as well as monthly zolendronic acid and oncologic management..

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