Two Cases of Diffuse Osteoblastic Metastases From Early Type Gastric Cancer

Intense 68Ga-DOTA-FAPI-04 Uptake in Diffuse Sclerotic Skeletal Metastases of Gastric Cancer

ABSTRACT

Diffuse sclerotic metastases of the bone as initial presentation at gastric carcinoma are very rare. We present a 48-year-old man who was examined for pancytopenia and diagnosed with gastric cancer. 18F-FDG PET/CT showed moderate uptake in the primary gastric tumor and mild uptake in diffuse sclerotic metastatic lesions in the bone matrix, whereas 68Ga-DOTA-FAPI-04 showed mild uptake in the gastric lesion and intense uptake at the whole skeleton.

Multiple Myeloma Presenting as Disseminated Osteoblastic Lesions With Intense 18F-FDG Uptake on PET/CT

ABSTRACT

A 42-year-old woman presented with numbness and weakness in the lower limbs. The radiograph, MRI, and 99mTc-MDP bone scintigraphy revealed multiple bone lesions. The lesions were sclerotic on radiograph. Subsequent 18F-FDG PET/CT showed the lesions were disseminated and had intense 18F-FDG uptake. Monoclonal lambda plasmacytoma was confirmed after CT-guided biopsy of the third lumbar vertebral lesion. The laboratory data also showed a monoclonal immunoglobulin G lambda protein in serum and urine immunofixation. The patient was diagnosed as multiple myeloma finally. Multiple myeloma should be in the differential diagnosis scope of multiple osteoblastic lesions with intense 18F-FDG uptake on PET/CT.

Paraneoplastic Hypocalcemia Developed in Gastric Cancer Accompanied by Osteoblastic Metastasis

Paraneoplastic syndromes are generally defined as clinical disorders associated with malignant diseases, and hypocalcemia associated with cancer is a rare condition. A woman in her 60s was referred to our hospital for the further examination of massive ascites due to carcinoma of unknown primary origin. She complained of numbness around her lips, and marked hypocalcemia of 5.0 mg/dL was noted. After two courses of chemotherapy, computed tomography showed a decrease in the ascites, and her serum calcium level increased. Although hypocalcemia is a very rare condition in patients with gastric cancer, serum calcium values should be evaluated when neurological symptoms are observed.