Gastric adenocarcinoma presenting with soft tissue masses

Patients with gastric adenocarcinoma typically present with symptoms that include anorexia, early satiety, and weight loss. Although the disease may already be far advanced at presentation, signs and symptoms from involvement of skeletal muscle are extremely uncommon. In fact, metastatic cancer of any type to the skeletal muscles is rare, and most of these metastases are discovered at autopsy. We report here the case of a 65-yr-old man who presented with complaints of weight loss, early satiety, bloating, and swelling and tenderness in his upper thighs. Endoscopy with biopsy revealed invasive, poorly differentiated gastric adenocarcinoma. Biopsy of one of the thigh masses displayed the same findings. The patient initially responded well to an investigational protocol with high-dose 5-fluorouracil, with regression of the thigh masses and palliation of his pain.