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Case #1

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Expand Physical Exam

Patient presents with generalized abdominal pain and diarrhea. On exam the abdomen is soft with diffuse tenderness.

Expand Imaging

11/02/XX

Chest x-ray: negative
Upper GI: partial obstruction in antrum and pylorus.

11/06/XX

Liver scan: no definite focal defects.

Expand Laboratory

11/07/XX

CEA: 8.2 (within normal limits)

Expand Scopes

11/04/XX

Gastroscopy: Findings consistent with carcinoma.

Expand Surgical Observations

11/08/XX

Total gastrectomy with esophagojejunostomy and omentectomy: Entire stomach involved with tumor. Extensive involvement of regional lymph nodes and metastatic seeding in cul-de-sac. No palpable liver involvement.

Expand Pathological Reports

11/04/XX

Gastric washings and brush biopsy: mucinous adenocarcinoma consistent with gastric origin.

11/08/XX

Total stomach: infiltrating mucinous adenocarcinoma of stomach, grade III. Metastatic undifferentiated adenocarcinoma in all 5 perigastric lymph nodes that were examined. Proximal esophagus, distal duodenum, and omentum free of tumor. Tumor infiltrates entire wall of stomach to involve serosa.

Expand Treatment

11/08/XX

Surgery: Total gastrectomy with regional lymph node dissection.

12/04/XX

Chemotherapy recommended as palliative treatment option, patient has not decided whether to undergo treatments.