A case report of disseminated carcinomatosis of the bone marrow from early gastric cancer 4 years after operation

Abstract

The patient was a 39–year–old man who had undergone distal gastrectomy for gastric cancer at the age of 35. When the pathological diagnosis was made as 0–IIc, T1(m), N1, M0, tub2sig, ly0, v0, stageIB. Four years later the serum CA19–9 and ALP levels were elevated, but no metastatic leasions were pointed out by CT and echogram. PET–CT performed with a suspicion of cancer of unknown origin disclosed local uptake at the 2nd thoracic vertebra and ilium, and bone scintigram showed diffuse abnormal uptake (super bone scan). Disseminated carcinomatosis of the bone marrow from gastric cancer was diagnosed. Systemic chemotherapy was started, but the disease progressed to its termination.
Disseminated carcinomatosis of the bone marrow from gastric cancer do not form a metastatic tumor. When the serum CA19–9 and ALP levels are elevated in gastric cancer patients, bone scintigram should be taken in consideration of a possibility of disseminated carcinomatosis of the bone marrow.