Publication Name	World Journal of Gastrointestinal Oncology
Manuscript ID	109424
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Case Report
Article Title	Bone marrow metastasis of gastric signet ring cell carcinoma complicated by thrombotic microangiopathy: A case report
Manuscript Source	Unsolicited Manuscript
All Author List	Wei Sun, Xiao-Ci Chen, Han Wang, Wei-Yu Chang, Yun He, Zeng-Hua Lin, Hui Jia, Xiao-Mei Zhang and Hong Liu
Funding Agency and Grant Number	Funding Agency Grant Number the Research Project for Clinical Research on Precision Diagnosis and Innovative Treatment of Bone Marrow Failure 2024YFC2510500 Jiangsu Provincial Traditional Chinese Medicine Science and Technology Development Plan YB2020102 Nantong Municipal Health Commission Research Project QN2023007
Corresponding Author	Hong Liu, Chief Physician, MD, PhD, Professor, Department of Hematology, Affiliated Hospital of Nantong University, 688 Qingnian East Road, Nantong City, Nantong 226001, Jiangsu Province, China. hongliu63@126.com
Key Words	Gastric signet ring cell carcinoma; Thrombotic microangiopathy; Bone marrow metastasis; Bone marrow necrosis; Bone marrow fibrosis; Diagnosis and treatment; Case report
Core Tip	Thrombotic microangiopathy (TMA), characterized by microangiopathic hemolytic anemia and multi-organ failure, is a rare and underrecognized complication of malignancies. This report highlights a fatal case of gastric signet-ring cell carcinoma with bone marrow metastasis and TMA, diagnosed 15 months post-gastrectomy. TMA may precede cancer recurrence and is frequently misdiagnosed due to overlapping symptoms. Supportive therapies achieved transient remission, but discontinuation led to fatal progression. Currently, the disease is managed through plasma exchange, but evidence supporting efficacy of this treatment is lacking. This case demonstrates that TMA may be a potential early marker of aggressive malignancies and emphasizes the urgent need to clarify its pathogenesis and optimize treatment strategies for cancer-associated TMA.
Citation	Sun W, Chen XC, Wang H, Chang WY, He Y, Lin ZH, Jia H, Zhang XM, Liu H. Bone marrow metastasis of gastric signet ring cell carcinoma complicated by thrombotic microangiopathy: A case report. World J Gastrointest Oncol 2025; In press

Received	2025-05-12 08:56
Peer-Review Started	2025-05-12 08:56
To Make the First Decision
Return for Revision	2025-05-27 01:09
Revised	2025-06-07 13:02
Second Decision	2025-07-11 02:42
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-07-11 08:39
Articles in Press	2025-07-11 08:39
Publication Fee Transferred	2025-06-10 09:49
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Typeset the Manuscript

ISSN	1948-5204 (online)
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