A 63-year-old man with no past history of interest. He consulted for presenting a nodular lesion in the right dorso-lumbar quadrant of one month's evolution and rapid growth, associated with asthenia and anorexia for the last three months, with a weight loss of 10 kg. He reported no other symptoms. Physical examination revealed only a slight hepatomegaly. On the right dorsal-lumbar region there was a nodular lesion measuring 5x3 cm, purplish in colour, not adhering to deep layers but painful when rubbed or moved.

Laboratory tests showed urea 74 mg/dl, creatinine 1.93 mg/dl and GGT 83 IU/L with normal GOT/GPT. A chest X-ray showed an elevated left diaphragm and aortic elongation, with no other findings. A biopsy of the skin lesion was performed with an anatomopathological diagnosis of adenocarcinoma metastasis. In view of these findings, a thoraco-abdomino-pelvic CT scan was performed, which revealed thickening of the oesophago-gastric junction, with left gastric adenopathy >1cm in diameter and liver lesions suggestive of metastasis. Gastroscopy showed a lesion compatible with neoplasia of the cardia. Biopsy revealed adenocarcinoma. Given the diagnosis of metastatic gastric adenocarcinoma, the patient started chemotherapy treatment with cisplatin (70mg/m2 every 21 days) and 5-fluorouracil in a 48-hour continuous infusion every week (3 gr/m2, days 1,8,15). This regimen is one of the first-line treatments for this tumour and is included in the guidelines of the Spanish group for the treatment of tumours of the gastrointestinal tract (TTD). After the second cycle, he developed haematological toxicity with febrile neutropenia. He developed septic shock and died in that context.