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We present a unique case of a man in his late 50s with acute thrombocytopenia as the initial symptom, subsequently diagnosed with gastric cancer on bone marrow examination. Despite receiving chemotherapy, the patient\u2019s condition deteriorated rapidly, emphasising the challenging management and poor prognosis associated with DCBM. This case underscores the need for improved diagnostic strategies and therapeutic approaches to enhance patient outcomes in DCBM associated with gastric cancer.<\/jats:p>","DOI":"10.1136\/bcr-2024-260217","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T23:40:11Z","timestamp":1726875611000},"page":"e260217","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Metastatic gastric adenocarcinoma discovered in the bone marrow"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2730-2271","authenticated-orcid":false,"given":"Ekaterina","family":"Proskuriakova","sequence":"first","affiliation":[{"name":"Internal Medicine, Mount Sinai Hospital, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaisny","family":"Balamurali","sequence":"additional","affiliation":[{"name":"Ross University School of Medicine, Two Tree Hill St. Michael, Barbados"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuradha","family":"Hooda","sequence":"additional","affiliation":[{"name":"Haematology and Oncology, Mount Sinai Hospital, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paramjeet","family":"Khosla","sequence":"additional","affiliation":[{"name":"Haematology and Oncology, Mount Sinai Hospital, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,9,20]]},"reference":[{"key":"2025082707252562000_17.9.e260217.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20107"},{"key":"2025082707252562000_17.9.e260217.2","doi-asserted-by":"publisher","DOI":"10.1177\/030089169508100117"},{"key":"2025082707252562000_17.9.e260217.3","first-page":"505","article-title":"Acute disseminated intravascular coagulation syndrome in cancer patients","volume":"52","author":"Pasquini","year":"1995","journal-title":"Oncology (Williston Park, NY)"},{"key":"2025082707252562000_17.9.e260217.4","doi-asserted-by":"crossref","first-page":"164","DOI":"10.5230\/jgc.2014.14.3.164","article-title":"Bone metastasis from gastric cancer: the incidence, clinicopathological features, and influence on survival","volume":"14","author":"Turkoz","year":"2014","journal-title":"J Gastric Cancer"},{"key":"2025082707252562000_17.9.e260217.5","doi-asserted-by":"crossref","first-page":"160","DOI":"10.14744\/ejmo.2017.65365","article-title":"Gastric cancer patients with bone marrow metastasis: a single-center experience and review of the literature","volume":"1","author":"Ergun","year":"2017","journal-title":"EJMO"},{"key":"2025082707252562000_17.9.e260217.6","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197909)44:3&lt;1009::aid-cncr2820440331&gt;3.0.co;2-j"},{"key":"2025082707252562000_17.9.e260217.7","first-page":"4025","article-title":"Symptomatic bone marrow involvement in breast cancer--clinical presentation, treatment, and prognosis: a single institution review of 22 cases","volume":"31","author":"Kopp","year":"2011","journal-title":"Anticancer Res"},{"key":"2025082707252562000_17.9.e260217.8","first-page":"674","article-title":"Diffusely infiltrative carcinoma. 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