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

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.