Gastric adenocarcinoma with peritoneal spread

Case contributed by Dr Balint Botz

Presentation

Investigated for weight loss and malaise, endoscopy identified extensive gastric tumor

Patient Data

Age: 75 years
Gender: Female
  • The gastric wall is irregularly thickened (reaching 20-22 mm) and enhancing, involving both curvatures, the fundus and a part of the cardia.   Hiatal hernia can be also seen. 
  • Diffuse low density intraperitoneal free fluid.
  • Numerous grossly enlarged (15-30 mm short axis diameter) pathological lymph nodes mainly in the para-aortic region and around the lesser curvature and cardia of the stomach, and to a lesser extent in the mesenteric fat.
  • Several vividly-enhancing circumscribed rounded lesions in the peritoneum anteriorly, the largest of which measured 40 mm.
  • Other: subtle low density area in the 4B segment of the liver - possible focal deposition. Prior cholecystectomy, hysterectomy and adnexectomy,  small kidney cysts.

Altogether findings are consistent with an extensive gastric malignancy with disseminated lymphadenomegaly, peritoneal metastases, and resultant ascites.

Case Discussion

The case demonstrates a case of advanced gastric malignancy, endoscopic biopsy confirmed adenocarcinoma. The patient received palliative chemotherapy. 

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Case information

rID: 63290
Published: 24th Sep 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: University of Pécs

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