Gastric antropyloric adenocarcinoma

Case contributed by Dr Shervin Sharifkashani

Presentation

Abdominal pain, dyspepsia, decreased appetite, bloating, epigastric fullness, nausea, and intermittent vomiting for one month.

Patient Data

Age: 60 years
Gender: Male

Asymmetrically and circumferentially increased wall thickening with thickness up to 15-18 mm in the gastric antro-pyloric segment with partial gastric outlet obstruction and pronounced gastric distention upstream containing fluid and food residues are seen. There is no gross evidence of perigastric fat extension of the lesion. No significant lymph nodes and no solid organ metastasis are seen.

Both kidneys have decreased size, irregular margin, and multiple small parapelvic cysts with an impression on the adjacent pyelocaliceal system. Two calculi up to 3-4 mm in the left kidney and small dense calculus up to 4 mm in the gallbladder body lumen are seen. Pronounced DJD change and scoliosis in the spine are also noted.

Pathology report

Photo

The pathology report of endoscopic gastric antrum biopsy is intestinal-type Gastric adenocarcinoma.

Case Discussion

The case illustrates pathology-proved non-metastatic gastric adenocarcinoma located within the gastric antro-pyloric segment which has led to partial gastric outlet obstruction and pronounced gastric distention upstream.

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