Gastric adenocarcinoma

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain


Abdominal pain and dyspepsia.

Patient Data

Age: 70 years
Gender: Male

A 66×52mm pleural based well-defined opacity is noted at anterior segment of left upper lobe and superior segment of lingular lobe, adjacent to upper mediastinum. A few band like fibrotic opacities also are scattered at both lung fields.
Right sided aortic arch is noted.
Increased wall thickness as tumoral infiltration is present at gastric cardia and proximal portion of lesser curvature; accompanied by surrounding fat stranding. Multiple perigastric, peripancreatic and para-aortic lymphadenopathies are observed with maximum SAD of 28mm.
Two low- enhancing masses, 25mm and 20mm in diameters are noted at segment V and III of the liver, respectively.
A 28mm stone is noted within the gallbladder.
A few simple cortical cysts are seen at kidneys, less than 40mm in diameter.
The uterus is not seen due to prior resection.
Degenerative changes as osteophytosis are seen at the thoracolumbar spine.

Case Discussion

Gastric mass; path proven adenocarcinoma with regional and para-aortic lymphadenopathy, hepatic metastases and pulmonary opacity.
Right sided aortic arch and cholelithiasis are also observed.

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