Abstract
Although gastric cancer is a prevalent malignant tumor worldwide, gastric cancer with bone marrow metastasis is rare and associated with extremely poor prognosis. The clinical manifestations of bone marrow metastasis are diverse and nonspecific, with diagnosis primarily confirmed through bone marrow biopsy. (18)F fluorodeoxyglucose positron emission tomography/computed tomography ((18)F FDG PET/CT) serves as a sensitive modality for detecting bone marrow metastasis. We present a case of a female patient with gastric adenocarcinoma complicated by bone marrow metastasis, who presented with systemic pain and fatigue. (18)F FDG PET/CT revealed metabolically active lesions in the vertebral column and multiple skeletal sites, while conventional CT showed no apparent signs of bone destruction.