This patient went on to have a total gastrectomy after the stomach tumour was identified on gastroscopy.
HISTOLOGY
MACROSCOPIC DESCRIPTION: The specimen is a total gastrectomy. Arising from the body of the mucosa at the anterolateral aspect is a large friable tan centrally ulcerated round polypoid tumour mass 65 mm in diameter with markedly heaped up edges. At the site of the tumour the serosal surface shows marked indrawing, roughening and there is adherent fat. Macroscopically the tumour appears to extend through the wall to the serosal surface.
MICROSCOPIC DESCRIPTION: The tumour is adenocarcinoma with abundant gland formation and mucin secretion (so-called intestinal type). It infiltrates through the full thickness of stomach wall into adjacent fat. The surface is ulcerated and covered by abundant necrotic and inflammatory debris with abundant bacteria. Focally the tumour cells infiltrate as large solitary atypical cells and although the bulk of the tumour is moderately differentiated, at worst the tumour is considered poorly differentiated.
DIAGNOSIS: moderately and focally poorly differentiated adenocarcinoma