A rare initial presentation of gastric cancer with multiple osteolytic lesions.

Authors

Asad Jehangir, Department of Internal Medicine, Reading Health System, Spruce Street/6th Avenue, West Reading, PA 19610, USA.
Kim Aderhold, Department of Internal Medicine, Reading Health System, Spruce Street/6th Avenue, West Reading, PA 19610, USA.
Priya Rajagopalan, Department of Internal Medicine, Reading Health System, Spruce Street/6th Avenue, West Reading, PA 19610, USA.
Oluwaseun Shogbesan, Department of Internal Medicine, Reading Health System, Spruce Street/6th Avenue, West Reading, PA 19610, USA.
Sharon Swierczynski, Department of Pathology, Reading Health System, Spruce Street/6th Avenue, West Reading, PA 19610, USA.Follow
Anam Qureshi
Qasim Jehangir
Christian Espana Schmidt, Department of Hospital Medicine, Reading Health System, Spruce Street/6th Avenue, West Reading, PA 19610, USA.

Document Type

Article

Publication Date

4-23-2015

Abstract

Gastric cancer is the 12th leading cause of cancer-related deaths in the United States and commonly metastasizes to the bones. However, the presentation of gastric cancer as bony metastases without preceding gastrointestinal symptoms is rare which has been infrequently reported in the literature. Moreover, leptomeningeal carcinomatosis is an unusual complication of gastric cancer accounting for less than 1 percent of these patients. We present a unique case of a middle aged male who presented to the emergency department with worsening backache which started one month priorly. The only abnormal laboratory test was an elevated alkaline phosphatase of 154 IU/L. The imaging of his spine showed osteolytic lesions which on biopsy revealed signet ring cells. A small 2 cm ulcerated mass was found on esophagogastroduodenoscopy at the gastric cardia which on biopsy revealed signet ring gastric carcinoma. The patient received chemotherapy with capecitabine and oxaliplatin as well as radiation and showed a good response initially. A few months later, he presented with persistent worsening headaches and on brain imaging was found to have leptomeningeal carcinomatosis. Ten months after the diagnosis of gastric carcinoma, he passed away.

Publication Title

Case Rep Oncol Med

Volume

2015

First Page

689431

Last Page

689431

Comments

Epub

Recommended Citation

Jehangir, A., Aderhold, K., Rajagopalan, P., Shogbesan, O., Swierczynski, S., Qureshi, A., Jehangir, Q., & Espana Schmidt, C. (2015). A rare initial presentation of gastric cancer with multiple osteolytic lesions.. Case Rep Oncol Med, 2015, 689431-689431. https://doi.org/https://doi.org/10.1155/2015/689431