A case of occult malignancies with disseminated carcinomatosis of the bone marrow presenting with isolated elevation of serum alkaline phosphatase

VernacularTitle:以血清碱性磷酸酶显著升高为主要临床特点的合并骨髓播散的胃癌一例
Author: Yingying YANG ¹ ; Tao YUAN ; Qinglin LI ; Xinxin MAO ; Weibo XIA ; Huijuan ZHU
Author Information

1. 中国医学科学院，北京协和医学院，北京协和医院内分泌科，国家卫生健康委员会内分泌重点实验室　100730
Keywords: Alkaline phosphatase; Paget′s disease; Gastric cancer
From: Chinese Journal of Endocrinology and Metabolism 2021;37(11):1013-1016
CountryChina
Language:Chinese
Abstract: The measurement of serum alkaline phosphatase (ALP) levels has been widely used in the clinical setting. However, isolated elevation of serum ALP levels is also commonly seen and needs to be extensiuely evaluated Herein, we present a case of gastric adenocarcinoma with disseminated carcinomatosis of the bone marrow (DCBM). In this case, isolated elevation of serum ALP levels was the only clinical manifestation with no other notable symptom. Additionally, imaging studies including whole body computed tomography (CT) and positron emission tomography-CT (PET-CT) were all negative, which resulted in the misdiagnosis of Paget′s disease of bone initially. This highlights that malignancies involving bones presenting with isolated elevation of serum ALP levels might be misdiagnosed in asymptomatic individuals.