Diffuse osteosclerosis as a presentation of recurrent breast cancer: role of endothelin 1

Summary We report a 46-yr-old woman with a history of breast cancer who presented with diffuse myalgias, bone pain, and osteosclerosis. She was found to have recurrent breast cancer producing endothelin-1. Introduction Acquired osteosclerosis can be caused by various disorders. Endothelin -1 is beli...

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Bibliographic Details
Published in:Osteoporosis international 2019-08, Vol.30 (8), p.1699-1703
Main Authors: Zarnecki, K. G., Kristianto, J., Charlson, J., Wilson, B., Blank, R. D., Shaker, J. L.
Format: Article
Language:English
Subjects:
Adenocarcinoma - diagnostic imaging
Adenocarcinoma - metabolism
Adenocarcinoma - secondary
Adenocarcinoma - therapy
Autopsy
Biopsy
Bone cancer
Bone growth
Bone marrow
Bone Neoplasms - complications
Bone Neoplasms - diagnostic imaging
Bone Neoplasms - metabolism
Bone Neoplasms - secondary
Breast cancer
Breast Neoplasms - metabolism
Case Report
Endocrinology
Endothelin 1
Endothelin-1 - physiology
Endothelins
Fatal Outcome
Female
Hormone replacement therapy
Humans
Immunohistochemistry
Medicine
Medicine & Public Health
Metastases
Metastasis
Middle Aged
Orthopedics
Osteogenesis
Osteosclerosis
Osteosclerosis - diagnostic imaging
Osteosclerosis - etiology
Osteosclerosis - metabolism
Pain
Paracrine signalling
Radiography
Rheumatology
Skin diseases
Skin Neoplasms - metabolism
Skin Neoplasms - secondary
Vertebrae
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Summary:Summary We report a 46-yr-old woman with a history of breast cancer who presented with diffuse myalgias, bone pain, and osteosclerosis. She was found to have recurrent breast cancer producing endothelin-1. Introduction Acquired osteosclerosis can be caused by various disorders. Endothelin -1 is believed to contribute to osteosclerosis caused by breast cancer. Methods Although the bone marrow biopsy did not reveal breast cancer, she developed skin lesions consistent with metastatic breast cancer. She ultimately died from progressive disease. At autopsy immunohistochemistry for endothelin-1 was performed on a section from the L5 vertebral body. Results The section from the L5 vertebral body showed small foci of cells consistent with metastatic carcinoma and a prominent sclerotic response. Immunohistochemistry for endothelin-1 was strongly positive. Conclusions Recurrent breast cancer may present with diffuse osteosclerosis. Endothelin-1 may be a paracrine factor responsible for increased bone formation and osteosclerosis.
ISSN:0937-941X
1433-2965
DOI:10.1007/s00198-019-04998-5