COVER LETTER
From
Dr.EzhilArasi.N,
Professor and HOD,
Upgraded department of pathology,
Osmania medical college/Osmania general hospital,
Hyderabad,Telangana state.
To
The Editor-in-Chief,
INDJSRT, India.
Respected sir/madam,
I am herewith submitting an article with “TITTLE: ATYPICAL INITIAL PRESENTATION OF GASTRIC CARCINOMA - METASTATIC DEPOSITS OF SIGNET RING CELL ADENOCARCINOMA IN BONE MARROW.” for kind consideration and publication in your esteemed journal. Awaiting early response and acknowledgement.
Thanks and regards.
Dr.EzhilArasi.N
Corresponding author –
Dr.Neelaveni .N
Assistant professor,
Upgraded department of pathology
Osmania medical college, Hyderabad,telangana.
Address – flat no.201, Vijaya Krishna residency,kalyanpuri,…show more content… Gastric malignancies with bone marrow metastasis are still rarer. We present this case of ours in a 30yr female, clinically presented with pyrexia, generalised weakness and altered sensorium. Haematological work up revealed a leucoerythroblastic picture and elevated serum alkaline phosphatase level. Bone marrow aspiration yielded a dry tap. Bone marrow trephine biopsy was done which helped in arriving at final diagnosis. Further investigations revealed a diffuse growth in the stomach. Bone marrow metastasis is a rare but possible in certain types of gastric carcinoma. With the increasing incidence of diffuse type gastric adenocarcinoma bone marrow metastases may likely play a greater role in the presentation and management of gastric…show more content… Patients with cancer of solid organs are subjected to bone marrow study for staging and to detect metastases. In adults the tumors that most often metastasise to bone marrow are carcinomas of the prostate, lung in males, breast and genitourinary carcinomas in females and aero digestivetract malignancies in both the genders. Although any tumor that gives rise to blood borne metastases may infiltrate the marrow (1, 2).
Gastric carcinoma is the third most common gastrointestinal (GI) malignancy after colon and pancreatic carcinoma accounting for a significant worldwide cancer burden. Metastasis to the bone and/or bone marrow is uncommon in patients with gastric carcinoma. However, in patients with bone marrow metastasis from solid tumors, gastric cancer accounts for the majority. (3)
CASE DETAILS
We present a case of 30yr old female, clinically presenting as a case of fever, generalised weakness and altered sensorium. On physical examination patient was febrile, pallor was present, no generalised lymphadenopathy and no organomegaly.Biochemical investigations revealed an elevated serum alkaline phosphatase level-888 U/L. (Normal range is 44 to 147