title: [A case of rapidly fatal gastric cancer with disseminated carcinomatosis of the bone marrow].
abstract: A 50-year-old man underwent thorough examination for a chief complaint of melena. Gastric cancer and right kidney cancer were diagnosed. The gastric cancer was in the antrum, and poorly differentiated adenocarcinoma was diagnosed by biopsy. The right kidney cancer was diagnosed as clear cell carcinoma by computed tomography-guided biopsy. We performed right nephrectomy and distal gastrectomy. The final diagnosis of the gastric cancer was por2, pT3( ss), pN3b( 46/ 61), M0, pStage IIIB, R0, and that of the kidney cancer was clear cell carcinoma, pT3a, pN0, pM0. The patient reported lower back pain approximately 2 months after surgery. Several examinations revealed that the patient had multiple bone metastases, disseminated carcinomatosis of the bone marrow, and disseminated intravascular coagulation (DIC).We treated the bone metastasis with denosumab and palliative radiation therapy and the gastric cancer with weekly paclitaxel (PTX). The DIC subsided during the first course but recurred during the discontinuation period. We attempted additional trastuzumab treatment but did not achieve a curative effect, and the patient died. It is necessary to provide appropriate medical care while taking into consideration the possibility of disseminated carcinomatosis of the bone marrow in cases with a high likelihood of lymph node metastasis.
authors.affiliation: Dept. of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine.
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Kimura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kawasaki
authors.forename: Naoki
authors.initials: N
authors.lastname: Wajima
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakai
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Shinnosuke
authors.initials: S
authors.lastname: Yonaiyama
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hakamada
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols; D019046:Bone Marrow Neoplasms / Q000188:drug therapy / Q000556:secondary*; D018450:Disease Progression; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D017809:Fatal Outcome; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000972:Antineoplastic Agents, Phytogenic; D000068878:Trastuzumab; D017239:Paclitaxel