An interesting case of gastric adenocarcinoma presenting as bicytopenia in young adult

Abstract

A 28-year-old male with no prior comorbidities came with chief complaints of loss of weight for 4 months, generalised weakness for 1 month and blackish discolouration of stools for 20 days. On general examination, pallor present; rest of the physical examination was normal. Laboratory investigations showed low haemoglobin (4.8 g/dL) and platelet count (10,000/mm³). Atypical cells were present in the peripheral blood smear and accounted for 4%. packed red blood cells and platelet-rich plasma transfusions were given. As the blood counts were not improving, bone marrow aspiration and biopsy were done which showed metastatic signet-ring cell carcinoma. In view of melaena, endoscopy was done, which showed carcinoma stomach with active bleeding. The patient was diagnosed to have metastatic signet-ring cell adenocarcinoma with bone marrow metastasis. In view of the advanced nature of disease, the patient was given palliative and supportive treatment.