Infiltrating gastric adenocarcinoma with disseminated osteoblastic metastases
Palabras clave:
Adenocarcinoma. Bone metastasis. Gastric tumor.Resumen
We report the case of a man with a diagnosis of invasive gastric adenocarcinoma associated with scattered osteoblastic metastases. This 65-year-old patient was admitted with nausea, vomiting and abdominal pain, in addition to loss of weight (13 Kg in 3 months). Upper digestive endoscopy revealed extensive infiltrating changes in the body of the stomach, and histopathologic data confirmed the diagnosis of a Borrmann IV gastric adenocarcinoma. Complementary exams were indicative of a gastric cancer with bone metastases, characterized by disseminated osteoblastic images of the scintigraphy of the skeleton. Palliative chemotherapy was the treatment of first choice. High serum levels of CA 19-9, CEA and alkaline phosphatase can constitute useful indicative tools of this challenging condition. Images from a scintigraphy study of the skeleton can characterize the type and extension of bone metastases. The aim of this case study is to report a case of a very uncommon condition, considering that disseminated osteoblastic metastases rarely develop in this kind of tumor.
Descargas
Citas
1. ARDANAZ E, MORENO-IRIBAS C, PÉREZ DE RADA ME, EZPONDA C, FLARISTÁN Y, NAVARIDAS N et al. Incidencia y mortalidad por cáncer en Navarra, 1998-2002. Evolución en los últimos 30 años. An Sist Sanit Navar 2007; 30: 245-270.
https://doi.org/10.4321/S1137-66272007000300009
2. SÁNCHEZ MJ, PAYER T, DE ANGELIS R, LARRAÑAGA N, CAPOCACCIA R, MARTINEZ C for the CIBERESP Working Group. Cancer incidence and mortality in Spain: estimates and projections for the period 1981-2012. Ann Oncol 2010; 21: iii30-36.
https://doi.org/10.1093/annonc/mdq090
3. SANTOS VM, CASTRO ECC, ARAÚJO AC, REIS MA, TEIXEIRA VPA. Budd-Chiari syndrome and unsuspected gastric adenocarcinoma. Medicina (Ribeirão Preto) 2005; 38: 156-160.
https://doi.org/10.11606/issn.2176-7262.v38i2p156-160
4. MACCAURO G, SPINELLI MS, MAURO S, PERISANO C, GRACI C, ROSA MA. Physiopathology of spine metastasis. Intern J Surg Oncol 2011; 107969. Epub 2011 Aug 10.
https://doi.org/10.1155/2011/107969
5. ESCUISSATO DL, LEDESMA JA, URBAN LABD, LIU CB, REIS FILHO JS, OLIVEIRA FILHO AG et al. Metástase de câncer gástrico simulando neoplasia primária de pulmão - relato de caso e revisão da literatura. Radiol Bras 2002; 35: 121-124.
https://doi.org/10.1590/S0100-39842002000200015
6. AHN JB, HA TK, KWON SJ. Bone metastasis in gastric cancer patients. J Gastric Cancer 2011; 11: 38-45.
https://doi.org/10.5230/jgc.2011.11.1.38
7. AMOROSO V, PITTIANI F, GRISANTI S, VALCAMONICO F, SIMONCINI E, FERRARI VD et al. Osteoblastic flare in a patient with advanced gastric cancer after treatment with pemetrexed and oxaliplatin: implications for response assessment with RECIST criteria. BMC Cancer 2007; 7: 94.
https://doi.org/10.1186/1471-2407-7-94
8. CCHUNG YS, CHOI TY, HA CY, KIM HM, LLEE KJ, PPARK CH et al. An unusual case of osteoblastic metastasis from gastric carcinoma. Yonsei Med J 2002; 43: 377-380.
https://doi.org/10.3349/ymj.2002.43.3.377
9. MARTI J, SAINZ M. Unusual late metastasis from gastric carcinoma. Saudi J Gatroenterol 2011; 17: 423-424.
https://doi.org/10.4103/1319-3767.87188
10. ANAGNOSTOPOULOS G, SAKORAFAS GH, KOSTOPOULOS P, MARGANTINIS G, TSIAKOS S, PAVLAKIS G. Early (mucosal) gastric cancer with synchronous osteosclerotic bone metastases: a case report. Eur J Cancer Care (Engl) 2010; 19: 554-557.
https://doi.org/10.1111/j.1365-2354.2007.00847.x
11. IBÁÑEZ FJ, AZAGRA JS, GOERGEN M, BORDAS JM, ALMENDRAL ML, ERRO JM. Cirugía laparoscópica del cáncer gástrico. An Sist Sanit Navar 2005; 28: 21-31.
https://doi.org/10.4321/S1137-66272005000600004
12. BEN AHARON O, PURIM O, KUNDEL Y, BRENNER R, GORDON N, SULKES A et al. The combination of docetaxel, cisplatin, and 5-fluorouracil in advanced gastric cancer: a single-institution experience. Anticancer Drugs. 2012 Jan 10. [Epub ahead of print]
https://doi.org/10.1097/CAD.0b013e32834fd780
13. KONG JH, LEE J, YI CA, PARK SH, PARK JO, PARK YS et al. Lung metastases in metastatic gastric cancer: pattern of lung metastases and clinical outcome. Gastric Cancer 2011; Oct 29. [Epub ahead of print]
Descargas
Archivos adicionales
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2013 Anales del Sistema Sanitario de Navarra
Esta obra está bajo una licencia internacional Creative Commons Atribución-CompartirIgual 4.0.
La revista Anales del Sistema Sanitario de Navarra es publicada por el Departamento de Salud del Gobierno de Navarra (España), quien conserva los derechos patrimoniales (copyright ) sobre el artículo publicado y favorece y permite la difusión del mismo bajo licencia Creative Commons Reconocimiento-CompartirIgual 4.0 Internacional (CC BY-SA 4.0). Esta licencia permite copiar, usar, difundir, transmitir y exponer públicamente el artículo, siempre que siempre que se cite la autoría y la publicación inicial en Anales del Sistema Sanitario de Navarra, y se distinga la existencia de esta licencia de uso.
