Isolated metastatic lesion of hyoid bone in gastric cancer: A rare case

Background. Secondary hyoid tumors are extremely rare. There are few documented reports of metastases into hyoid in patients with distant localizations of malignancies, such as breast, lung, kidney, liver, and sigmoid colon cancers. The article describes a rare case of metastases of advanced gastric cancer to the hyoid bone. Aim. To present a clinical case of isolated metastatic lesion of the hyoid bone in a patient with primary advanced gastric cancer, demonstrating the possibility of increasing the duration and quality of life using polychemotherapy. Results. A 54-year-old male with synchronous pain in the throat and epigastrium when swallowing solid food and weight loss underwent esophagogastroduodenoscopy, which showed a defect in the mucosa along a small curvature in the middle third of the stomach. Histological examination showed colloid cancer. Combined positron-emission and X-ray computed tomography (PET/CT) with 18F-fluorodeoxyglucose (18F-FDG) revealed a gastric tumor with radiopharmaceutical hyper uptake, serous membrane invasion and involvement of paragastric, celiac, retroperitoneal, and mediastinal lymph nodes. The entire hyoid bone was swollen with fragmentary cortex destruction. Stage IV gastric cancer cT4bN3аM1 was diagnosed with metastases to the hyoid bone, mediastinal, and retroperitoneal lymph nodes. The patient received eight cycles of polychemotherapy with the XELOX regimen and reported the resolution of sore throat and epigastric pain. The results of PET/CT with 18F-FDG showed sclerosis of the cortical layer of the hyoid bone and no abnormal radiopharmaceutical uptake. The patient has been alive for 13 months. Conclusion. Hypoglossal bone metastases are extremely rare in patients with advanced colloid cancer. Such case was described for the first time. The method of choice for diagnosing and assessing the extent of the tumor is PET/CT with 18F-FDG. Palliative polychemotherapy can increase the duration and improve the quality of life.