Presentation
Work up for abdominal pain and dyspepsia.
Patient Data
Marked increased wall thickness with local dilatation is present at the gastric antrum, pylorus and proximal of the duodenum, which infiltrates adjacent liver and gallbladder. The fat plane between the mass and pancreatic head and neck is infiltrated, and local invasion is suspected.
Several enlarged lymph nodes are seen in the vicinity of the mass with SAD less than 18 mm. There are also several peritoneal tumoral deposits less than 30 mm.
A small amount of free fluid is present in the pelvis.
Degenerative changes such as osteophytosis are seen in the lumbar spine.
Grade I spondylolisthesis of L4 on L5 is present with bilateral spondylolysis.
Case Discussion
Locally advanced gastroduodenal mass, pathology proved adenocarcinoma with regional enlarged lymph nodes and peritoneal seeding.
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