Abstract
Early gastric cancer usually has a good prognosis following surgical treatment. However a small number of cases show extensive metastases to distant organs. We here report an unusual case of early gastric cancer detected by bone metastasis. An 81-year-old Japanese woman was referred to our hospital with a right ileac tumor, biopsy of which turned to be well-differentiated adenocarcinoma. After checking for the primary lesion, early gastric cancer with IIa type was determined by both upper gastrointestinal series and gastrofiberscopy. CT scan revealed lymph node swelling around the celiac artery, which was considered to be the cause of her epigastralgia. After radiotherapy for the iliac bone metastasis, subtotal gastrectomy was performed with the intention of relieving her epigastralgia. Although she could return to her ordinary daily life after the operation, regrowth of the iliac bone metastasis, paraaortic lymph nodes metastasis and multiple lung metastasis lead to her death nine months after the operation. Bone metastasis from gastric cancer is clinically rare, especially in early gastric cancer. Although no effective treatment for such intractable disease is established, it is expected that a new strategy combining surgery, chemotherapy and radiotherapy may improve the prognosis and QOL of patients.
