Gastric adenocarcinoma with peritoneal spread
Investigated for weight loss and malaise, endoscopy identified extensive gastric tumor
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- 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.
The case demonstrates a case of advanced gastric malignancy, endoscopic biopsy confirmed adenocarcinoma. The patient received palliative chemotherapy.