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Skeletal Radiology

, Volume 48, Issue 5, pp 813–817 | Cite as

Bone metastases with multiple fluid-fluid levels from gastric cancer: a case report and review of literature

  • Min Chen
  • Huishu YuanEmail author
Case Report
  • 112 Downloads

Abstract

We report the case of a 54-year-old man with 6 months of progressive sacral pain. Computed tomography showed a large osteolytic mass in the sacrum with multiple osteolytic foci in the ilium and lumbar spine. Magnetic resonance imaging revealed multiple fluid-fluid levels in the sacral lesion as well as in the lumbar foci. The multiple bone lesions were initially diagnosed as a primary sacral malignancy with multiple bone metastases. A biopsy of the sacral lesion under the guidance of computed tomography was performed and a metastatic adenocarcinoma from the stomach or lung was found pathologically. Finally, a gastric tubular adenocarcinoma was detected by endoscopic biopsy and the diagnosis of the patient was gastric cancer with uncommon multiple bone metastases.

Keywords

Metastasis Gastric cancer Fluid-fluid levels Bone tumors 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Jarraya M, Hayashi D, Lebreton C, Côté JF, Guermazi A, Vallée C. Isolated vertebral metastasis with a fluid-fluid level from a poorly differentiated adenocarcinoma. Diagn Interv Radiol. 2013;19(3):233–6.Google Scholar
  2. 2.
    O'Donnell P, Saifuddin A. The prevalence and diagnostic significance of fluid-fluid levels in focal lesions of bone. Skelet Radiol. 2004;33(6):330–6.CrossRefGoogle Scholar
  3. 3.
    Collet P, Daumont A, Amourdedieu J, Llorca G, Lejeune E. Pseudo-aneurysmal bone metastasis. Apropos of 6 new cases. Rev Rhum Mal Osteoartic. 1988;55(11):941–4.Google Scholar
  4. 4.
    Yu H, Cui JL, Cui SJ, Sun YC, Cui FZ. Differentiating benign from malignant bone tumors using fluid-fluid level features on magnetic resonance imaging. Korean J Radiol. 2014;15(6):757–63.CrossRefGoogle Scholar
  5. 5.
    Lum PA, Davis MJ, Orizaga M. Computed tomography fluid-fluid level in bone metastasis. Can Assoc Radiol J. 1990;41(5):296–9.Google Scholar
  6. 6.
    Nguyen BD, Westra WH, Kuhlman JE. Bone metastasis from breast carcinoma with fluid-fluid level. Skelet Radiol. 1996;25(2):189–92.CrossRefGoogle Scholar
  7. 7.
    Kickuth R, Laufer U, Pannek J, Adamietz IA, Liermann D, Adams S. Magnetic resonance imaging of bone marrow metastasis with fluid-fluid levels from small cell neuroendocrine carcinoma of the urinary bladder. Magn Reson Imaging. 2002;20(9):691–4.CrossRefGoogle Scholar
  8. 8.
    Bladt O, Demaerel P, Catry F, Van Breuseghem I, Ballaux F, Samson I. Multiple vertebral fluid-fluid levels. Skelet Radiol. 2004 Nov;33(11):660–2.CrossRefGoogle Scholar
  9. 9.
    Frenzel L, Javier RM, Eichler F, Zollner G, Sibilia J. Multiple fluid-filled bone metastases. Joint Bone Spine. 2010;77(2):171–3.CrossRefGoogle Scholar
  10. 10.
    Karadeniz E, Colangeli S, Ghermandi R, Gasbarrini A, Acaroğlu E, Boriani S. Aneurysmal bone cyst-like areas as a sign of metastatic disease in the spinal column. Acta Orthop Traumatol Turc. 2013;47(5):366–9.CrossRefGoogle Scholar
  11. 11.
    Colangeli S, Rossi G, Ghermandi R, Rimondi E. Fluid-fluid levels detected on MRI and mimicking primary aneurismal bone cysts in a case of spinal bone metastasis. Eur Rev Med Pharmacol Sci. 2014;18(1 Suppl):41–3.Google Scholar
  12. 12.
    Gundogdu F, Okur A, Atalay T, Tanik N, Karacavus S. Multiple vertebral metastasis with fluid-fluid level from a pleomorphic lobular breast carcinoma. Spine J. 2016;16(5):e303–4.CrossRefGoogle Scholar
  13. 13.
    Macedo F, Ladeira K, Pinho F, Saraiva N, Bonito N, Pinto L, et al. Bone metastases: an overview. Oncol Rev. 2017;11(1):321.CrossRefGoogle Scholar
  14. 14.
    Turkoz FP, Solak M, Kilickap S, Ulas A, Esbah O, Oksuzoglu B, et al. Bone metastasis from gastric cancer: the incidence, clinico-pathological features, and influence on survival. J Gastric Cancer. 2014;14(3):164–72.CrossRefGoogle Scholar
  15. 15.
    Tsai JC, Dalinka MK, Fallon MD, Zlatkin MB, Kressel HY. Fluid-fluid level: a nonspecific finding in tumors of bone and soft tissue. Radiology. 1990;175(3):779–82.CrossRefGoogle Scholar
  16. 16.
    Rapp TB, Ward JP, Alaia MJ. Aneurysmal bone cyst. J Am Acad Orthop Surg. 2012;20:233–41.CrossRefGoogle Scholar
  17. 17.
    Gerber S, Ollivier L, Leclère J, Vanel D, Missenard G, Brisse H, et al. Imaging of sacral tumours. Skelet Radiol. 2008;37(4):277–89.CrossRefGoogle Scholar
  18. 18.
    Si MJ, Wang CS, Ding XY, Yuan F, Du LJ, Lu Y, et al. Differentiation of primary chordoma, giant cell tumor and schwannoma of the sacrum by CT and MRI. Eur J Radiol. 2013;82(12):2309–15.CrossRefGoogle Scholar
  19. 19.
    Balke M, Schremper L, Gebert C, Ahrens H, Streitbuerger A, Koehler G, et al. Giant cell tumor of bone: treatment and outcome of 214 cases. J Cancer Res Clin Oncol. 2008;134(9):969–78.CrossRefGoogle Scholar
  20. 20.
    Murphey MD, wan Jaovisidha S, Temple HT, Gannon FH, Jelinek JS, Malawer MM. Telangiectatic osteosarcoma: radiologic-pathologic comparison. Radiology. 2003;229(2):545–53.CrossRefGoogle Scholar
  21. 21.
    Gao ZH, Yin JQ, Liu DW, Meng QF, Li JP. Preoperative easily misdiagnosed telangiectatic osteosarcoma: clinical-radiologic-pathologic correlations. Cancer Imaging. 2013;13(4):520–6.CrossRefGoogle Scholar
  22. 22.
    Simon RG, Irwin RB. An unusual presentation of telangiectatic osteosarcoma. Am J Orthop (Belle Mead NJ). 1996;25(5):375–9.Google Scholar

Copyright information

© ISS 2018

Authors and Affiliations

  1. 1.Peking University Third HospitalBeijingChina

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