Bone marrow infiltration by advanced gastric cancer: clinical case report
DOI:
https://doi.org/10.24054/cbs.v2i4.3293Keywords:
Bone marrow, gastric cancer, thrombocytopenia, adenocarcinomaAbstract
The presence of bone marrow metastasis secondary to gastric cancer is rare, since there is an incidence in bone tissue in a range of 0.9 to 13.4 % and bone marrow in only 0.024 %. In addition, they are considered to have a poor prognosis. The average age at which stomach cancer is diagnosed is 69 years, however, it tends to occur in younger patients. Patients with gastric cancer together with bone marrow metastasis have an average age of approximately 45 years. The most relevant findings to suspect this type of metastatic infiltration are the presence of hematological alterations, such as disseminated intravascular coagulation, hemolytic anemia, pancytopenia or persistent and marked thrombocytopenia, which is the most frequent, in addition to that, diagnostic images that reveal alterations in the bone structure as well as elevated levels of lactic dehydrogenase and alkaline phosphatase. This article presents the clinical case of a 49-year-old male patient in fair condition with an established diagnosis of advanced grade III gastric adenocarcinoma confirmed by esophagogastroduodenoscopy and histopathological study, which includes the pyloric antrum and upper body T4A staged by laparoscopy, who underwent total gastrectomy. Due to the presence of marked thrombocytopenia during his hospital stay with multiple transfusions, it was decided to perform an invasive bone marrow biopsy with suspicion of medullary carcinomatosis.
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Hu, B., El Hajj, N., Sittler, S., Lammert, N., Barnes, R., & Meloni-Ehrig, A. (2012). Gastric cancer: Classification, histology, and application of molecular pathology. Journal of gastrointestinal oncology, 3(3), 251–261. https://doi.org/10.3978/j.issn.2078-6891.2012.021
Lauren p. (1965). The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. an attempt at a histo-clinical classification. Acta pathologica et microbiologica scandinavica, 64, 31–49. https://doi.org/10.1111/apm.1965.64.1.31
Sánchez E. (2017). Adenocarcinoma Gástrico (Gastric adenocarcinoma). Revista Médica Sinergia, 2(1), 13-21.
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