Gastric adenocarcinoma

Case contributed by Ryan Thibodeau
Diagnosis certain

Presentation

Generalized abdominal pain.

Patient Data

Age: 75 years
Gender: Male
ct

Gastrointestinal:

Case Discussion

This is a case of an incidental finding of a gastric adenocarcinoma. The thickening of the lesser curvature of the gastric wall with acute luminal margins were highly suggestive of malignancy. The sclerotic bony lesions, abdominopelvic adenopathy, and hypoattentuated lesions in the liver were suggestive of diffuse metastases.

A CT-guided biopsy of the proximal stomach was obtained which revealed gastric mucosa with moderately pleomorphic and mitotically abundant infiltrating tumor cells within the lamina propria with a signet ring cell appearance. These findings were consistent with an invasive adenocarcinoma.

The patient followed with colorectal oncology as an outpatient who determined the disease was not amendable to surgery. The patient refused chemotherapy and wanted to pursue hospice.

CO-AUTHORS:
Andy Lam, DO
Christine Cooley, MD

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