Gastro-esophageal carcinoma (recurrence)
Progressive dysphagia in a patient operated for perforated gastro - esophageal adenocarcinoma and underwent two cycles of chemotherapy.
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Post surgical status of esophagogastric junction with a trilobulated large chunk of tumor deposit recurring and sitting infiltration left hemidiaphragm, along the superolateral margin of existing gastro - esophageal junction, transecting proximal suture. Enhancing soft tissue mass is seen transmural involving greater curvature of stomach at site of distal anastomotic suture. Post splenectomy status. Loss of fat planes with left lobe of liver. Few perigastric enhancing discrete lymph nodes.
This patient due to a perforation of the upper GIT had to undergo a reconstructive surgery despite having advanced locally. Whilst a grave prognosis was suggested to the patient, the surgeon referred the patient for a repeat imaging to look for feasibility of stenting for palliation. The necrotic nature of the deposits is evident by the poor enhancement of the central areas of the deposits.