Bone marrow necrosis secondary to metastatic adenocarcinoma revealed by (18)F-FDG PET/CT: A clinical case report

RATIONALE: Bone marrow necrosis (BMN) is a rare malignancy-associated hematologic disorder characterized by necrosis of myeloid and stromal marrow elements with preservation of cortical bone. PATIENT CONCERNS: A 43-year-old female complaining of dizziness and vaginal bleeding for more than 2 months was presented to our department. DIAGNOSIS: Due to the laboratory test results, radiographic findings, especially (18)F-fluoro-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) which revealed that bone marrow was characterized by diffuse (18)F-FDG uptake with extensive central photopenia, and pathologic results, she was diagnosed with metastatic adenocarcinoma accompanied with BMN. And the cancer most likely originated from reproductive system or breast. INTERVENTIONS: There was no effective interventions for her before knowing the accurate origin of adenocarcinoma. OUTCOMES: Two weeks later, unfortunately, she died. LESSONS: (18)F-FDG PET/CT is a useful diagnostic modality in patients with BMN. Malignant tumor should always be considered in patients with extensive BMN, even in young people.