Gastric cancer initially presenting as bone metastasis: Two case reports and a literature review.
Gastric cancer initially presenting as bone metastasis: Two case reports and a literature review.
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DOI：
10.3892/ol.2018.9393
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发表时间：
2018-11
期刊：
影响因子：
2.9
通讯作者：
Koizumi T
中科院分区：
文献类型：
--
作者：
Gomi D;Fukushima T;Kobayashi T;Sekiguchi N;Sakamoto A;Mamiya K;Koizumi T
胃癌经常在手术后或临床病程后期扩散至区域淋巴结、肝脏和肺部。然而，胃癌患者最初出现骨转移的临床表现相对较少。目前的研究提出了两例胃癌弥漫性转移至脊柱的病例和单发转移至梯形的病例。第一个病例的最初表现是碱性磷酸酶水平升高，没有任何与骨转移相关的症状，第二个病例的拇指右侧腕掌关节肿胀。这些临床表现在胃癌骨转移中也极为罕见。该研究强调，对于碱性磷酸酶升高但无临床症状或仅有单一骨转移的患者，应考虑诊断为胃癌。
Gastric cancer frequently spreads to the regional lymph nodes, liver and lungs following surgery or late in the clinical course. However, an initial clinical presentation of bone metastasis in gastric cancer patients is relatively rare. The current study presents two cases of gastric cancer diffusely metastasized to the spinal vertebrae and with a single metastasis to the trapezium, respectively. The initial presentations were an increased alkaline phosphatase level without any symptoms associated with bone metastasis in the first case and a swelling in the right carpometacarpal joint of the thumb in the second case. These clinical manifestations are also extremely rare in gastric cancer with bone metastasis. The study emphasizes that a diagnosis of gastric cancer should be considered in patients with increased alkaline phosphatase without clinical symptoms or with a single bone metastasis.
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