Diffuse Bone Metastases as the Initial Presentation of Gastric Adenocarcinoma: A Rare and Atypical Case Report
Faman Douaya Sano *
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Abdoul Karim Poudiougou
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Hamadoun Traoré
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Adil Debbagh
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Imane Sella
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Abdelkarim Antari
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Imane Chahbounia
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Sofia El Omri
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Imad Taleb
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Mohammed Amine Saad
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Saida Lamine
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Mohammed Anouar Mokhlis
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Lamiaa Aalaoui
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Mohammed Reda Khmamouche
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Choukri Elm'hadi
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Khaoula Alaoui Slimani
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Yassir Sbitti
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Tarik Mahfoud
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
Hassan Errihani
National Institute of Oncology, Morocco.
Rachid Tanz
Medical Oncology Departement, Mohammed V Military Training Hospital, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: The occurrence of skeletal metastases is generally indicative of an adverse prognosis. Despite the immediate negative impact of bone involvement on cancer outcomes, accurate identification of the primary tumour is critical.
Aim: We report the unusual case of a 58-year-old man who initially presented with persistent right shoulder pain that rapidly became generalized and refractory to standard analgesics, in a context of profound functional decline and significant weight loss. Diagnostic evaluation revealed a poorly differentiated gastric adenocarcinoma with upfront bone metastases.
Discussion: Bone dissemination occurs in approximately 10% of gastric cancers and is therefore relatively rare. The originality of this case lies in its inaugural presentation as isolated bone pain in the absence of typical gastrointestinal symptoms, associated with bicytopenia and markedly elevated serum tumor markers.
Conclusion: This case underscores the importance of considering an underlying digestive malignancy in patients presenting with unexplained bone disease, particularly when biological abnormalities are suggestive.
Keywords: Bone metastases, gastric adenocarcinoma, bone pain, biological abnormalities, bicytopenia