A case of occult malignancies with disseminated carcinomatosis of the bone marrow presenting with isolated elevation of serum alkaline phosphatase / 中华内分泌代谢杂志

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.