Super bone scan due to bone marrow metastases appearing 19 years after surgery for early gastric cancer--a case report.
A 54 year old man presenting a so-called super bone scan is reported. The patient had a past history of subtotal gastrectomy due to early gastric cancer 19 years previously. Laboratory data indicated microcytic anemia and high serum alkaline phosphatase. Both the serum calcium and phosphate levels were within normal ranges. In spite of extensive examination for a primary malignant lesion in the organs including the remaining stomach, no solid tumors were identified. Pathological examinations revealed that the tumor cells in the biopsy specimen from the lumbar spine were almost identical to those in the gastric cancer excised 19 years previously. We considered that micrometastases in the bone marrow existed at the time of the initial surgery for gastric cancer and reappeared 19 years later showing super bone scan.
Omi
Rei
R
Department of Orthopaedic Surgery, Kurihara Central Hospital, 25 Sakuramachi, Aza-Simomiyano, Tsukidate, Kurihara-gun, Miyagi, 987-2203, Japan.
Hatori
Masahito
M
Sano
Hirotaka
H
Watanabe
Kazuhiro
K
Watanabe
Mika
M
Kokubun
Shoichi
S
D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery; D019046:Bone Marrow Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary*; D005743:Gastrectomy; D006801:Humans; D007120:Immunochemistry; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D013669:Technetium Tc 99m Medronate; D015899:Tomography, Emission-Computed, Single-Photon
D013669:Technetium Tc 99m Medronate