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- W2980257072 abstract "INTRODUCTION: With over 1,000,000 new cases of gastric cancer in 2018, and 783,000 estimated deaths, gastric cancer remains an important cancer worldwide. 1 Gastric malignancy will commonly present in patients with weight loss and persistent abdominal pain. Patients can also present with findings of metastatic disease. This clinical vignette is an example of a rare metastatic location of gastric cancer. CASE DESCRIPTION/METHODS: 55-year-old Middle Eastern male presents with intractable low back pain. An MRI of the thoracic and lumbar spine revealed multiple osseous lesions of the thoracic vertebral bodies and fractures of the L2 and L3 vertebral bodies, concerning for metastasis (Figure 1). A CT of the chest, abdomen and pelvis revealed enlarged mediastinal and hilar lymph nodes. Enlarged lymph nodes at the gastrohepatic interval and celiac level measuring up to 2 cm were noted, and multiple enlarged mesenteric and retroperitoneal lymph nodes. The patient underwent bone biopsy during kyphoplasty of the L2 and L3 vertebrae, which revealed metastatic carcinoma. Serum markers of malignancy were unrevealing, a CA19-9 of 15, CEA of 7.1, and PSA of 0.74. Urology was consulted and cystoscopy performed. No mass or filling defect was noted, and urine cytology returned negative for malignant cells. Gastroenterology was consulted and upon further history, the patient did acknowledge a history of H. Pylori, in 2016, with eradication confirmed by a negative stool antigen test. Gastroenterology recommended EGD and colonoscopy, but patient was unable to tolerate the bowel prep. The patient underwent an EGD, which revealed a 3.0 × 3.5 cm, cratered gastric ulcer without stigmata of bleeding at the incisura (Figure 2). Biopsy of this ulcer was positive for adenocarcinoma. DISCUSSION: This case demonstrates a presentation of bony metastasis of gastric cancer. This metastatic location is rare and unusual. It highlights the importance of maintaining high clinical suspicion in patients with metastatic disease. Additionally, it reinforces the relevance of a multidisciplinary approach when evaluating malignancy." @default.
- W2980257072 created "2019-10-18" @default.
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- W2980257072 date "2019-10-01" @default.
- W2980257072 modified "2023-09-23" @default.
- W2980257072 title "2721 Back Pain Can Be Hard to Digest" @default.
- W2980257072 doi "https://doi.org/10.14309/01.ajg.0000600416.83796.01" @default.
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