A Case of Bone Metastasis from Gastric Carcinoma after Twelve-year Disease-Free Interval

Kohei Wakatsuki, Yukishige Yamada, Michihiro Narikiyo, Masatou Ueno, Hidetoshi Tamaki, Katsuhiko Miki, Sohei Matsumoto, Koji Enomoto and Yoshiyuki Nakajima

Department of Surgery, Nara Medical University

We present a case of very late and unusual recurrence of gastric carcinoma. A 54-year-old man underwent total gastrectomy with D3 LN cleaning for gastric carcinoma in April 1992. Histologically, the tumor was signet-ring cell carcinoma stage II (T2, N1, P0, H0, M0). Postoperatively, he was treated with oral 5-fluorouracil and PSK for three years without evidence of recurrence. He suddenly developed lumbago in August 2004 and was diagnosed with a pressure fracture at the thoracic and lumbar spine. Pathologic fracture was suspected, so we conducted bone biopsy. Histologically, the biopsy specimen was signet-ring cell carcinoma, leading to a diagnosis of multiple bone metastasis from gastric carcinoma. Chemotherapy and radiotherapy were started using a regimen of S-1 (80 mg/body weight) +CDDP (10 mg/body weight) and 30 Gy for the thoracic and lumbar spine. Tumor markers decreased and pain was relieved, but the man was died of disseminated intravascular coagulation two months later.

Key words
gastric carcinoma, bone metastasis, long disease-free interval

Reprint requests
Kohei Wakatsuki Department of Surgery, Nara Medical University
840 Shijo-cho, Kashihara, 634-8522 JAPAN

Accepted
May 31, 2006

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