title: Widespread osteoblastic metastases and marked elevation of CA19-9 as a presentation of signet ring cell gastric carcinoma.
abstract: Widespread osteoblastic metastases, as well as marked elevations of CA19-9 and carcino-embryonic antigen (CEA), are the initial manifestations of gastric signet ring cell carcinoma. CT Imaging revealed diffuse sclerotic metastases in the axial skeleton. It was only following gastric biopsy that the primary site of metastatic bone tumor was identified. Recent studies suggest that early diagnosis of cancer origin, including tumor molecular profiling, may dictate specific therapy, improve prognosis and increase patient survival rates.
authors.affiliation: 1 The Ruth and Bruce Rappaport Faculty of Medicine and Research Institute, Technion-Israel Institute of Technology, Haifa, Israel ; 2 Department of Pathology, Bnai-Zion Medical Center and The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel ; 3 Department of Internal Medicine, Bnai Zion Medical Center, Haifa, Israel and The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Link
authors.affiliation: 1 The Ruth and Bruce Rappaport Faculty of Medicine and Research Institute, Technion-Israel Institute of Technology, Haifa, Israel ; 2 Department of Pathology, Bnai-Zion Medical Center and The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel ; 3 Department of Internal Medicine, Bnai Zion Medical Center, Haifa, Israel and The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Asaf
authors.initials: A
authors.lastname: Romano
authors.affiliation: 1 The Ruth and Bruce Rappaport Faculty of Medicine and Research Institute, Technion-Israel Institute of Technology, Haifa, Israel ; 2 Department of Pathology, Bnai-Zion Medical Center and The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel ; 3 Department of Internal Medicine, Bnai Zion Medical Center, Haifa, Israel and The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Bejar
authors.affiliation: 1 The Ruth and Bruce Rappaport Faculty of Medicine and Research Institute, Technion-Israel Institute of Technology, Haifa, Israel ; 2 Department of Pathology, Bnai-Zion Medical Center and The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel ; 3 Department of Internal Medicine, Bnai Zion Medical Center, Haifa, Israel and The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Elad
authors.initials: E
authors.lastname: Schiff
authors.affiliation: 1 The Ruth and Bruce Rappaport Faculty of Medicine and Research Institute, Technion-Israel Institute of Technology, Haifa, Israel ; 2 Department of Pathology, Bnai-Zion Medical Center and The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel ; 3 Department of Internal Medicine, Bnai Zion Medical Center, Haifa, Israel and The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Dotan
keywords: CA19-9; Gastric signet ring cell carcinoma; carcino-embryonic antigen (CEA); osteoblastic metastases