Lytic bone lesion as the first manifestation of late recurrence of gastric cancer

Abstract

The incidence of gastric cancer has declined worldwide, it is the second most common cancer worldwide and two thirds of these occurs in developing countries. In Peru, this neoplasm, has one of the highest incidence and mortality rates. The main sites of gastric adenocarcinoma metastasis are the liver and lung; In contrast, bone metastasis are an uncommon finding up to 0.9 to 2% of patients and is associated with an ominous prognosis. We present the case of a 48-year-old female patient diagnosed with gastric cancer treated surgically and with regular controls. 5 years later, she was admitted due to pain in the left knee and increased volume. Knee radiographs reported a lytic lesion in the medial condyle and distal diaphysis of the left femur, with soft tissue involvement, wide transition zone, cortical rupture. Bone scintigraphy described bone oligo metastatic disease. Extension studies were negative for visceral metastasis. Palliative biopsy and curettage of the femur lesion was performed; the pathology was consistent with gastric adenocarcinoma metastasis.