We report the case of a man with a diagnosis of invasive gastric adenocarcinoma associated with scattered osteoblastic metastases. This 65-year-old patient was admitted with nausea, vomiting and abdominal pain, in addition to loss of weight (13 Kg in 3 months). Upper digestive endoscopy revealed extensive infiltrating changes in the body of the stomach, and histopathologic data confirmed the diagnosis of a Borrmann IV gastric adenocarcinoma. Complementary exams were indicative of a gastric cancer with bone metastases, characterized by disseminated osteoblastic images of the scintigraphy of the skeleton. Palliative chemotherapy was the treatment of first choice. High serum levels of CA 19-9, CEA and alkaline phosphatase can constitute useful indicative tools of this challenging condition. Images from a scintigraphy study of the skeleton can characterize the type and extension of bone metastases. The aim of this case study is to report a case of a very uncommon condition, considering that disseminated osteoblastic metastases rarely develop in this kind of tumor.Key words. Adenocarcinoma. Bone metastasis. Gastric tumor. RESUMENPresentamos un caso de adenocarcinoma gástri-co infiltrante asociado con metástasis osteoblásticas diseminadas. Un paciente de 65 años ingresó con náu-seas, vómitos y dolor abdominal asociados con pérdida de peso (13 Kg en 3 meses). La endoscopia digestiva objetivó extensas alteraciones infiltrativas del cuerpo gástrico y los datos histopatológicos confirmaron el diagnóstico de adenocarcinoma gástrico Borrmann IV. Exámenes complementarios fueran indicativos de cán-cer gástrico con metástasis óseas, caracterizadas por imágenes osteoblásticas diseminadas de la cintilografía del esqueleto. Se le administró quimioterapia paliativa como primera opción. Se elevó CA 19-9, CEA y apareció fosfatasis alcalina en el suero un indicador útil del diagnóstico. La extensión y el tipo de metástasis óseas pueden ser imágenes de cintilografías del esqueleto. Este caso tiene como objetivo describir la presencia de metástasis osteoblásticas diseminadas que raramente son producidas por este tipo de tumor.Palabras clave. Adenocarcinoma. Metástasis óseas. Tumor gástrico.

Background: Hepatic resection for liver metastasis from breast cancer (LMBC) canattain long-term survival. Since BC has been a very sensitive neoplasm to chemotherapy, surgical resection of residual LMBC has presented an important role associated withsystemic therapy. Reverse approach ("first liver approach") has been performed for liver metastasis from colorectal cancer (LMCRC), mainly for multiple synchronic metastases that have presented partial response. Case report: We report a case of LMBC in young female who has undergone successful"first liver approach" after partial response tosystemic therapy. At first, it was performed open right hepatectomy with caudate lobectomy and atypical resection of three small lesions in left lobe. After two postoperative cycles of chemotherapy associated a target therapy, she has finally submitted a radical mastectomy and selective axillary lymphadenectomy. To date, thirty months after hepatic resection, she is alive without any recurrence.