Gastric Adenocarcinoma Presenting with Pathological Femoral Neck Fracture and Diffuse Skeletal Metastasis: A Case Report

Abstract

Gastric cancer rarely presents with bone metastasis, and initial skeletal involvement without gastrointestinal symptoms is exceptional—a 64-year-old man presented with left hip pain after a minor fall. Imaging revealed a femoral neck fracture and diffuse osteolytic lesions. Bone scintigraphy showed a super scan pattern. Further workup identified a gastric cardia mass; biopsy confirmed poorly differentiated adenocarcinoma with signet ring cells. Despite surgical fixation, the patient rapidly declined and died from disseminated intravascular coagulation. The present case highlights the importance of considering gastric cancer in patients with unexplained fractures and diffuse skeletal lesions.