Scaphoid metastasis as the first sign of occult gastroesophageal junction cancer: A case report

Figure 1 Imaging findings in the left hand. A: Plain X-ray showed a decrease in scaphoid bone density accompanied by a fracture; B and C: Computed tomography and magnetic resonance imaging scans demonstrated scaphoid and triangular bone destruction and soft tissue swelling, indicating a pathological fracture.

Figure 2 Preoperative chest computed tomography. A: A right upper lobe mass; B: A lower esophageal and stomachus cardiacus mass.

Figure 3 A preoperative 2-¹⁸F fluoro-2 deoxy-D-glucose positron emission tomography-computed tomography scan showed multiple malignant lesions throughout the whole body. This led to a strong suspicion of gastroesophageal junction and/or right lung malignancies with multiple metastases.

Figure 4 Preoperative gastroscopy did not find any space-occupying lesions.

Figure 5 Intraoperative photographs and postoperative pathological results. A: Pathological biopsy confirmed scaphoid bone metastasis of poorly differentiated adenocarcinoma. Immunohistochemistry showed CDX2 positivity (200×); B: The scaphoid bone was completely removed.