Publication Name	World Journal of Gastrointestinal Oncology
Manuscript ID	106848
Country	China

Category	Oncology
Manuscript Type	Case Report
Article Title	Extensive bone metastases from an occult gastric primary: A case report
Manuscript Source	Unsolicited Manuscript
All Author List	Chao-Bo Jin, Yong-Sheng Li, Juan Zhang, Jian Wu and Wei-Jing Tao
Funding Agency and Grant Number
Corresponding Author	Wei-Jing Tao, MD, Professor, Department of Nuclear Medicine, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huaiyin District, Huai’an 223300, Jiangsu Province, China. weijingtao2021@vip.163.com
Key Words	astric cancer; Bone metastasis; Fibroblast activation protein inhibitor; Positron emission tomography/computed tomography; Occult primary tumor; Case report
Core Tip	This case highlights an octogenarian with occult gastric cancer manifesting as extensive osteoblastic metastases initially misdiagnosed as rheumatoid arthritis. While fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) failed to detect the primary lesion, gallium-68 fibroblast-activation protein inhibitor PET/CT identified a subtle gastric antral tumor. This underscores the diagnostic utility of fibroblast activation protein inhibitor-targeted PET/CT imaging for gastrointestinal malignancies with low fluorine-18 fluorodeoxyglucose avidity and emphasizes the multidisciplinary integration of tumor markers, advanced imaging, and endoscopic surveillance in high-risk patients to detect clinically silent, aggressive cancers and mitigate diagnostic delays.
Citation	Jin CB, Li YS, Zhang J, Wu J, Tao WJ. Extensive bone metastases from an occult gastric primary: A case report. World J Gastrointest Oncol 2025; In press

Received	2025-03-13 03:28
Peer-Review Started	2025-03-13 03:28
To Make the First Decision
Return for Revision	2025-03-27 01:40
Revised	2025-04-09 12:20
Second Decision	2025-05-20 02:45
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-05-20 06:43
Articles in Press	2025-05-20 06:43
Publication Fee Transferred	2025-04-14 03:26
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5204 (online)
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