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.