Metastatic gastric carcinoma

Case contributed by Michael P Hartung
Diagnosis almost certain


Painless melena.

Patient Data

Age: 80
Gender: Male

Partially circumferential irregular mass of the gastric antrum. Adjacent stranding and adenopathy extending into the mesentery.

Gastrohepatic ligament adenopathy.

Numerous liver metastases. 


POSTPROCEDURE DIAGNOSIS: Obvious malignancy in the antrum of the stomach.

Operation: EGD with biopsy.

Description: There was melenic fluid in the stomach. There was an obvious large malignancy in the antrum of the stomach which was photographed. The pylorus was identifiable and intubated. The first through third portions of the duodenum as well as the duodenal bulb were carefully inspected and felt to be normal. The scope was returned to the stomach. The fungating mass in the antrum was photographed and biopsied for histologic evaluation. There was a small amount of bleeding which seemed to spontaneously subside with the biopsy. Within the stomach, there were no other mucosal abnormalities, polyps, or masses identified or ulcers.

Case Discussion

Gastric adenocarcinoma is the most common primary gastric malignancy. It often presents with advanced disease due to producing few early symptoms (as in this case, where the patient had painless anemia). It is an aggressive tumor with poor prognosis. 

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