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Updated: Jul 30, 2026
08:49
Models of Bone Metastasis
Published on: September 4, 2012
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Extensive bone metastases from an occult gastric primary: A case report
Chao-Bo Jin1, Yong-Sheng Li2, Juan Zhang3
1Department of Nuclear Medicine, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huai'an 223300, Jiangsu Province, China.
World Journal of Gastrointestinal Oncology
|June 23, 2025
Summary
A rare case of gastric cancer with widespread bone metastases was initially misdiagnosed as rheumatoid arthritis due to bone pain. Advanced imaging identified the occult gastric tumor, highlighting the need for high-risk surveillance.
Area of Science:
- Oncology
- Radiology
- Gastroenterology
Background:
- This case report details a rare instance of a small gastric cancer presenting with extensive bone metastases.
- The patient's primary symptom was chronic bone pain, leading to an initial misdiagnosis of rheumatoid arthritis.
Observation:
- An 83-year-old male presented with a year of worsening joint pain and markedly elevated alkaline phosphatase.
- Skeletal imaging revealed diffuse radiotracer uptake, initially suggesting Paget's disease, but tumor markers and biopsy confirmed metastatic adenocarcinoma.
- Gallium-68-labeled fibroblast-activation protein inhibitor PET/CT identified increased uptake in the gastric antrum, leading to gastroscopy and diagnosis of a 1.0 cm ulcerated gastric mass.
Findings:
- Histopathological evaluation confirmed poorly differentiated adenocarcinoma of the stomach.
- Bone metastases from gastric cancer are exceptionally rare, particularly with such diffuse skeletal involvement.
Implications:
- This case underscores the importance of considering occult malignancies in patients with unexplained bone pain and elevated alkaline phosphatase.
- Proactive high-risk surveillance strategies are crucial for early detection of gastric cancer with bone metastases.
- Multidisciplinary collaboration is essential for improving diagnostic accuracy and patient outcomes in rare oncological presentations.
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