title: Super bone scan due to bone marrow metastases appearing 19 years after surgery for early gastric cancer--a case report.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Kurihara Central Hospital, 25 Sakuramachi, Aza-Simomiyano, Tsukidate, Kurihara-gun, Miyagi, 987-2203, Japan.
authors.forename: Rei
authors.initials: R
authors.lastname: Omi
authors.forename: Masahito
authors.initials: M
authors.lastname: Hatori
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Sano
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Mika
authors.initials: M
authors.lastname: Watanabe
authors.forename: Shoichi
authors.initials: S
authors.lastname: Kokubun
mesh_terms: 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
chemical_list: D013669:Technetium Tc 99m Medronate