BACKGROUND Gastric cancer (GC) with bone metastasis is rare, and rib metastasis is even lesscommon. The clinical prognosis of GC with bone metastasis is poor given the lackof an effective treatment.CASE SUMMARY A 70 y...BACKGROUND Gastric cancer (GC) with bone metastasis is rare, and rib metastasis is even lesscommon. The clinical prognosis of GC with bone metastasis is poor given the lackof an effective treatment.CASE SUMMARY A 70 year old man was referred to Shaoxing People’s Hospital with left chest painand slight dyspnea. Chest computed tomography (CT) revealed a metastaticlesion in the left 3rd rib. Esophagogastroduodenoscopy revealed several ulcers inthe angle and antrum of the stomach, and tumor biomarkers including CEA andCA-199 were clearly increased. In addition, lymph node metastasis in the lessercurvature of the stomach was identified by positron emission tomography/CTscanning. Further pathological examination confirmed metastatic adenocarcinomain the rib and medium-low differentiated adenocarcinoma in the gastric space.The patient had GC with rib metastasis, and was clinically staged as T3NxM1 (IVB).Based on multidisciplinary team opinions, the patient received five courses ofchemotherapy (CAPOX plus aptinib), and then underwent rib resection andlaparoscopic radical distal gastrectomy. The patient started four courses ofchemotherapy after surgery, and then capecitabine and aptinib were administeredorally for 3 mo. Follow-up was performed on an outpatient basis usingabdominal/chest CT and tumor biomarkers. The patient exhibited an overallsurvival greater than 2 years, and the disease-free survival was approximately 18mo. His adverse events were tolerable.CONCLUSION The incidence of GC with rib metastases is extremely low, and patients can obtainmore benefits from individualized treatment formulated by multidisciplinaryteam. Chemotherapy plus surgery might represent an alternative option for GCwith rib metastasis.展开更多
文摘BACKGROUND Gastric cancer (GC) with bone metastasis is rare, and rib metastasis is even lesscommon. The clinical prognosis of GC with bone metastasis is poor given the lackof an effective treatment.CASE SUMMARY A 70 year old man was referred to Shaoxing People’s Hospital with left chest painand slight dyspnea. Chest computed tomography (CT) revealed a metastaticlesion in the left 3rd rib. Esophagogastroduodenoscopy revealed several ulcers inthe angle and antrum of the stomach, and tumor biomarkers including CEA andCA-199 were clearly increased. In addition, lymph node metastasis in the lessercurvature of the stomach was identified by positron emission tomography/CTscanning. Further pathological examination confirmed metastatic adenocarcinomain the rib and medium-low differentiated adenocarcinoma in the gastric space.The patient had GC with rib metastasis, and was clinically staged as T3NxM1 (IVB).Based on multidisciplinary team opinions, the patient received five courses ofchemotherapy (CAPOX plus aptinib), and then underwent rib resection andlaparoscopic radical distal gastrectomy. The patient started four courses ofchemotherapy after surgery, and then capecitabine and aptinib were administeredorally for 3 mo. Follow-up was performed on an outpatient basis usingabdominal/chest CT and tumor biomarkers. The patient exhibited an overallsurvival greater than 2 years, and the disease-free survival was approximately 18mo. His adverse events were tolerable.CONCLUSION The incidence of GC with rib metastases is extremely low, and patients can obtainmore benefits from individualized treatment formulated by multidisciplinaryteam. Chemotherapy plus surgery might represent an alternative option for GCwith rib metastasis.
