Metastatic Bone Lesion Type in Gastric Cancer Patients: Imaging Findings of Case Reports

Background: Gastric cancer (GC) is the fifth most common cancer globally and the third leading cause of cancer-related deaths. While it predominantly metastasizes to the liver, peritoneum, and lungs, bone metastasis (BM) is a rare but severe complication. BM occurs in 1-20% of GC cases and is associated with a poor prognosis. Typically, BM in GC presents at advanced stages, often with non-specific symptoms, making early detection challenging.

Case Description: This retrospective study analyzed 118 GC patients treated at our institution from 2010 to 2020. Among them, eight patients (6.8%) developed BM, with an equal split between osteoblastic and osteolytic types. Osteoblastic BM was observed exclusively in men, with a mean age of 72.25 years. The median time from GC diagnosis to BM onset was 27.5 months. BM was primarily detected through periodic thoracoabdominal CT scans, and bone scintigraphy confirmed the osteoblastic nature of the lesions. All patients had advanced GC and were under palliative care at the time of BM diagnosis. The average survival time from BM diagnosis was 8.5 months.

Conclusions: BM in GC patients is rare but significantly worsens the prognosis. The findings suggest that osteoblastic BM may be more common in GC than previously reported, potentially due to improved imaging techniques and extended patient survival. This study underscores the importance of vigilant radiological monitoring in GC patients, particularly those with non-specific symptoms suggestive of BM. Enhanced collaboration between oncology and palliative care teams is essential to manage symptoms effectively and improve patient quality of life. Future research should focus on the incidence and management of BM in GC, particularly the role of targeted therapies in improving patient quality of life.

Keywords: Bone metastasis (BM); gastric cancer (GC); osteoblastic; disease progression; case report.