Horiuchi et al. Our caseaAgea) 11 17 15Sex female male male malePrimary website Durationb), months Sizec), cm Ulcer on surface femor femor humerus sternum 14 30 30 11 4 3 two.5 Yes Yes Yes YesSymptoms hematemesis, anemia tarry stools, vomiting, anemia abdominal discomfort hematemesis, Consent form, and also the Healthcare Outcomes Study-Short Form-36 (MOS SF-36) and asymptomatic anemiaAge at diagnosis of key tumor; bduration from operation of main tumor to diagnosis of gastric metastasis; csize of gastric metastasis.Urakawa et al. World Journal of Surgical Oncology 2013, 11:48 http://www.wjso.com/content/11/1/Page 4 ofpreoperative and postoperative chemotherapy with ifosfamide and doxorubicin. We also utilised carboplatin and etoposide as a palliative chemotherapy immediately after postoperative recurrence mainly because ambulatory remedy is probable for these drugs. Menuck et al. reported 17 gastric metastases in autopsies of 1,010 individuals with cancers; 10 of those 17 did not have clinical manifestations . Interestingly, all prior reports showed that gastric metastases of osteosarcoma had PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/28242652 ulceration on the surface with the gastric metastasis, as in our case, when 3 of 4 cases had anemia and all had clinical manifestations [5-7]. In these prior reports of osteosarcoma gastric metastasis, gastric tumor excision was Rythromycin have to be evaluated in other research about this situation [10- performed in two of three situations having a wide or radical margin [6,7]. In our case, partial gastrectomy was performed by laparoscopy to stop re-bleeding from the ulcerated portion on the gastric metastasis. Earlier reports and our case indicate that gastrectomy was performed of necessity in sufferers who had symptoms of ulcer hemorrhage. VEGF expression in osteosarcoma was reported to be connected using a higher possible for pulmonary metastasis . In our case, the gastric osteosarcoma metastasis expressed abundant VEGF advertising the formation of new blood vessels out of a preexisting vascular network. Immature new vessels might be related with uncomplicated bleeding from the ulcer around the osteosarcoma gastric metastasis. Ulceration just isn't widespread in skin metastases of osteosarcoma , but is distinctive for gastric metastases of osteosarcoma. Local variables in the metastatic web-site may also be implicated in the occurrence of ulceration.diagnosis; AH performed the surgical therapy of your gastric metastasis. All authors read and approved the final manuscript. Author details 1 Department of Orthopedic Surgery, Nagoya University Graduate College and College of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan. 2 Department of Gastroenterology and Hepatology, Nagoya University Graduate School and College of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan. 3Division of Surgical Oncology, Division of Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan. Received: 14 December 2012 Accepted: 15 February 2013 Published: 26 February 2013 References 1. Marina N, Gebhardt M, Teot L, Gorlick R: Biology and therapeutic advances for pediatric osteosarcoma. Oncologist 2004, 9:422?41. two. Mirabello L, Troisi RJ, Savage SA: Osteosarcoma incidence and survival rates from 1973 to 2004: data in the Surveillance, Epidemiology, and End Benefits Program. Cancer 2009, 115:1531?543. 3. Nishida Y, Isu K, Ueda T, Nishi.Imens which incorporated cisplatin and/or methotrexate has been reported to be low in middle-aged and older patients [11,12], we administeredTable 1 Prior reports PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/25609842 of osteosarcoma gastric metastasisAuthors Overberg-Schmidt et al.