Presentation
Abdominal discomfort.
Patient Data
Age: 40 years
Gender: Male
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Diffuse thickening and enhancement of the stomach wall.
Gastrohepatic ligament adenopathy. Omental thickening/nodules. Ascites. Few upper abdominal varices.
Case Discussion
Infiltrative type of gastric adenocarcinoma confirmed at the time of surgery (linitis plastica).
When differentiating this from gastric wall thickening from inflammation or peptic ulcer disease, notice the degree of soft tissue enhancement of the entire wall. Submucosal edema from inflammation is usually lower in attenuation and enhances less than the mucosa (such as in this case).
The presence of gastrohepatic ligament adenopathy and carcinomatosis confirms the malignant diagnosis.