Fujita Isao, Toyokawa Tatsuya, Makino Takafumi, Matsueda Katsunori, Omote Shizuma, Horii Joichiro
Department of Gastroenterology, National Hospital Organization, Fukuyama Medical Center, Fukuyama, Hiroshima 720-8520, Japan.
Mol Clin Oncol. 2020 Mar;12(3):202-207. doi: 10.3892/mco.2020.1985. Epub 2020 Jan 22.
Bone metastasis during the early stages of gastric cancer is rare, and synchronous bone metastasis is even less common. The present report outlines a case of a small early gastric cancer, which was detected due to bone metastasis. A 63-year-old man was referred to Fukuyama Medical Center with back pain and anorexia of 2 weeks' evolution. MRI revealed multiple metastatic lesions in the thoracic and spinal bone. Fluorodeoxyglucose positron emission tomography revealed focal uptake in the lesser curvature of the stomach and in the spinal bone, pelvic and thigh bone, but uptake was not detected in the stomach. Esophagogastroduodenoscopy revealed a 10 mm slightly elevated lesion with a central depression in the middle-third of the stomach. Endoscopic ultrasonography confirmed that the tumor was confined to the mucosa. A biopsy specimen acquired from the gastric lesion indicated signet-ring cell carcinoma, and the specimen acquired from the lumbar spine revealed cell aggregation such as that found in signet-ring cell carcinoma. The patient received first-line chemotherapy with S-1 and cisplatin, and second-line chemotherapy with nab-paclitaxel. However, the patient died 120 days after consultation at Fukuyama Medical Center.
胃癌早期发生骨转移较为罕见，同时性骨转移更为少见。本报告概述了一例因骨转移而被发现的早期小胃癌病例。一名63岁男性因背痛和厌食2周前来福山医疗中心就诊。磁共振成像显示胸段和脊柱骨有多处转移灶。氟脱氧葡萄糖正电子发射断层扫描显示胃小弯、脊柱骨、骨盆和大腿骨有局灶性摄取，但胃内未检测到摄取。食管胃十二指肠镜检查发现胃中上部有一个10毫米的轻度隆起病变，中央凹陷。内镜超声检查证实肿瘤局限于黏膜层。从胃部病变获取的活检标本显示为印戒细胞癌，从腰椎获取的标本显示有印戒细胞癌中所见的细胞聚集。患者接受了S-1和顺铂一线化疗以及白蛋白结合型紫杉醇二线化疗。然而，患者在福山医疗中心就诊120天后死亡。
