• Ping Dong, Rong Tian, Lin Li, and Minggang Su.
• Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, P.R. China.
• Medicine (Baltimore). 2017 Dec 1; 96 (49): e9067.

RationaleBone 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 ConcernsA 43-year-old female complaining of dizziness and vaginal bleeding for more than 2 months was presented to our department.DiagnosisDue to the laboratory test results, radiographic findings, especially F-fluoro-2-deoxy-D-glucose (F-FDG) positron emission tomography/computed tomography (PET/CT) which revealed that bone marrow was characterized by diffuse 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.InterventionsThere was no effective interventions for her before knowing the accurate origin of adenocarcinoma.OutcomesTwo weeks later, unfortunately, she died.LessonsF-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.

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