Bilateral metastasis to the femoral head as the only manifestation of recurrence of gastric adenocarcinoma: a case repor
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Open Access
Case report
Bilateral metastasis to the femoral head as the only manifestation of recurrence of gastric adenocarcinoma: a case report Ma Jesus Fernández-Aceñero* and Teresa Aramendi Sánchez Address: Department of Surgical Pathology, Hospital General of Móstoles, Móstoles, Madrid (Spain) Email: Ma Jesus Fernández-Aceñero* - [email protected]; Teresa Aramendi Sánchez - [email protected] * Corresponding author
Published: 18 September 2003 World Journal of Surgical Oncology 2003, 1:18
Received: 28 July 2003 Accepted: 18 September 2003
This article is available from: http://www.wjso.com/content/1/1/18 © 2003 Fernández-Aceñero and Aramendi Sánchez; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
gastric tumorsneoplasmadenocarcinomafemursurgerycarcinomarecurrencebonemetastasis
Abstract Background: Metastases to the bone as the sole manifestation of recurrence of a gastric carcinoma are extremely rare. Case report: We herein report the case of a 63-year-old man operated a year and a half before for a poorly differentiated gastric carcinoma affecting the fundus, who developed bilateral metastasis to the femoral head as the sole manifestation of recurrence. He was treated with radiotherapy to control pain with a poor response and both femoral heads had to be eventually resected. Conclusions: We review the literature on the rare occurrence of osseous metastasis from gastric carcinoma and comment briefly on the therapeutic options for these cases.
Introduction
Case report
Gastric carcinoma is a frequent tumor, specially in some parts of the world, like Japan [1]. Metastasis to the bone from gastric tumors seem to be rare and have been estimated to appear in 13.4% of the autopsy cases of gastric carcinoma in a Japanese study [2]. It mainly affects patients with poorly differentiated tumors and widespread disease along with metastasis to other sites [2]. Another study on resected tumors rendered a 1.2% incidence of osseous metastasis [3]. Metastases to the bone can occasionally be the first manifestation of the gastric tumor [4–6], but have only rarely been described as the sole manifestation of tumor recurrence [7,8]. We herein report a rather unusual case of synchronous bilateral femoral head metastases from gastric carcinoma 1 1/2 years after successful resection of the tumor without evidence of recurrence elsewhere.
A 61-year-old man consulted on weight loss and dysphagia. He referred no medical antecedents of interest, other than hypertension under medical and dietetical control and renal stones. He was a moderate smoker (< 10 cigarrettes/day) and a social drinker. The barium swallow revealed a sliding hiatal hernia with a repletion defect inside. Endoscopy confirmed the presence of a huge mass in the herniated gastric fundus, and biopsy revealed adenocarcinoma. As the extension study (including CT scan) showed no metas
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