Disseminated ovarian, bone, and bone marrow metastases from gastric cancer

The main cause of death in patients with gastric cancer is disease dissemination. It is not clear why gastric cancer metastasizes to different organs. Early detection and destruction of circulating malignant cells before developing metastases may markedly improve survival of these patients. Krukenberg tumors (metastases of non-gynecological origin in the ovaries) usually are circular cell carcinomas of gastric cancer. Bone metastases of gastric cancer are rare, but if they are diagnosed, patients survive only 2–5 months on the average. Disseminated bone marrow metastases from gastric cancer do not always show the sudden course of the disease, but hematological complications are signs of poor prognosis. Hematological paraneoplastic disorders can be miscellaneous: they usually manifest as anemia of various origin, as leucocytosis in half of the patients, as leukemoid reactions in one-third of the patients, and as hemolysis and thrombocytopenia in half of the patients (often with disseminated intravascular coagulation). Currently, chemotherapy is the most effective treatment for outspread gastric cancer. Unfortunately, there is no exclusively effective scheme for treatment. Lymph node metastases are more sensitive to chemotherapy than primary gastric cancer, while in contrary, hepatic metastases are less sensitive than primary gastric cancer. This article includes a literature review and a rare case of gastric cancer