title: A case of bone marrow recurrence from gastric carcinoma after a nine-year disease-free interval.
abstract: 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.
authors.affiliation: Department of Surgical Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: N
authors.initials: N
authors.lastname: Noda
authors.forename: T
authors.initials: T
authors.lastname: Sano
authors.forename: K
authors.initials: K
authors.lastname: Shirao
authors.forename: H
authors.initials: H
authors.lastname: Ono
authors.forename: H
authors.initials: H
authors.lastname: Katai
authors.forename: M
authors.initials: M
authors.lastname: Sasako
authors.forename: K
authors.initials: K
authors.lastname: Maruyama
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019046:Bone Marrow Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D018279:Carcinoma, Signet Ring Cell / Q000000981:diagnostic imaging / Q000556:secondary*; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D005472:Fluorouracil / Q000008:administration & dosage; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D011877:Radionuclide Imaging; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery
chemical_list: D005472:Fluorouracil; D008727:Methotrexate