Pancytopenia and Hypocalcemia: An Unexpected Cause.

Authors

Gabriela Paulo, Carolina Veiga, Marco Oliveira Dias, Ilda Coelho

Published in

Cureus. Volume 18. Issue 9. Pages e116031. Epub Sep 10, 2026.

Abstract

Pancytopenia refers to the simultaneous reduction of all peripheral blood cell lines and is a hematologic finding often indicative of severe and potentially life-threatening disease. Although usually not associated, hypocalcemia and pancytopenia may co-occur, suggesting a common etiology. We report a case of a caucasian woman in her late 50s with asthenia, paraesthesia and nausea. Laboratory results showed severe hypocalcemia, anemia, elevated alkaline phosphatase and lactate dehydrogenase. A computed tomography scan revealed extensive osteosclerosis, suggesting osteoblastic metastasis. Progression to pancytopenia prompted bone marrow evaluation, ultimately leading to the diagnosis of signet-ring cell gastric adenocarcinoma. Unfortunately, the patient died shortly after diagnosis. This case illustrates a rare presentation of gastric adenocarcinoma, featuring hypocalcemia due to osteoblastic metastases and pancytopenia from bone marrow infiltration - an association infrequently reported in the literature - and emphasizes that this unusual constellation of findings may be the first clue to an otherwise unsuspected solid malignancy.

PMID:
42859735
Bibliographic data and abstract were imported from PubMed on 11 Oct 2026.

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