Paget’s disease of bone resembling bone metastasis from gastric cancer
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Yasuyuki Shimoyama Motoyasu Kusano Yoko Shimoda Shingo Ishihara Yoshitaka Toyomasu Tetsuro Ohno Erito Mochiki Takaaki Sano Junko Hirat
- چاپ و سال / کشور: 2011
Description
A 74-year-old man had an endoscopic type 00-IIc tumor in the upper gastric body on the greater curvature and biopsy showed the tumor to be a well-differentiated adenocarcinoma (Group 5). He was referred to us for endoscopic submucosal dissection (ESD). Endoscopy revealed fold convergency, fold swelling, and fusion of the fold, indicating tumor invasion into the submucosa, which was outside the indications for ESD. In addition, there was an increase of serum bone-type alkaline phosphatase (ALPIII and ALP-IV) and urinary cross-linked N-terminal telopeptide of type I collagen (a bone metabolism marker), while 18F-fluorodeoxyglucose positron emission tomography showed increased uptake in the left pelvis and Th10, suggesting bone metastases. We first diagnosed gastric cancer with bone metastases; however, the symptoms suggested pathological bone fracture and no bone pain. Therefore, a computed tomography-guided aspiration bone biopsy was performed to exclude the possibility of Paget’s disease of bone. Biopsy specimens revealed no tumor and a mosaic pattern. No increased uptake of 18F-FAMT (L-[3-18F] a-methyltyrosine) supported a diagnosis of no bone metastases from gastric cancer. We finally diagnosed gastric cancer accompanied by Paget’s disease of bone and performed a laparoscopy-assisted proximal gastrectomy. The pathological diagnosis was U less 0-IIb, and U post 0-IIc ypT1a (M) N0H0P0M0 yp stage IA. In gastric cancer patients with suspected bone metastasis, we also need to consider Paget’s disease of bone.
Clin J Gastroenterol (2011) 4:207–211 Received: 1 March 2011 / Accepted: 25 April 2011 / Published online: 4 June 2011 Springer 2011
