PMC5498197_01
PMC5498197_02
Contrast-enhanced CT showed massive ascites (a) and an abnormal bone formation adjacent to the thoracic spine (b, arrow).
1349-7235-56-1345-g001.jpg
PMC5498197_02_1349-7235-56-1345-g001.jpg
g001
Contrast-enhanced CT demonstrated massive ascites (Fig. 1a), but there were no lung or liver tumors. It also revealed an abnormal bone formation adjacent to the thoracic spine (Fig. 1b arrow).
Bone scintigraphy demonstrated the increased uptake of 99m-technetium diffusely throughout the skeleton, showing a 'beautiful bone scan'.
1349-7235-56-1345-g002.jpg
PMC5498197_02_1349-7235-56-1345-g002.jpg
g002
There was no increased uptake in the kidneys (Fig. 2).
PMC5498197_03
Clinical course of the case. The serum calcium level was increased and the CEA level decreased due to chemotherapy.
1349-7235-56-1345-g003.jpg
PMC5498197_03_1349-7235-56-1345-g003.jpg
g003
The serum calcium level was also increased (Fig. 3).
EGD demonstrated a slightly depressed pale lesion with fold convergence (a). In images with indigocarmine spray (b), encroachment and swelling of the converging folds were enhanced, and narrow band imaging with magnification (c) showed irregular microvessels on the surface of the lesion. Histopathology of a biopsy specimen showed a poorly differentiated tubular adenocarcinoma (d).
1349-7235-56-1345-g004.jpg
PMC5498197_03_1349-7235-56-1345-g004.jpg
g004
A slightly depressed pale lesion with fold convergence was found in the upper body (Fig. 4a-c). A histopathological examination of a biopsy specimen from the lesion revealed a poorly differentiated tubular adenocarcinoma (Fig. 4d), which was consistent with the histopathology of the disseminated nodules.