A case of bone marrow recurrence from gastric carcinoma after a nine-year disease-free interval

We present a case of very late and unusual recurrence of gastric cancer. Nine years following total gastrectomy for gastric carcinoma, a 57-year-old man presented with disseminated intravascular coagulation associated with bone marrow recurrence. The primary tumor was a signet ring cell carcinoma invading the subserosal layer with lymph node metastasis. The patient was treated with sequential administration of methotrexate and 5-fluorouracil and went into remission. After treatment, he survived 10 months. Autopsy revealed diffuse bone marrow infiltration and distant lymph node metastasis with signet ring carcinoma cells.