Click an information source below to view the case history.
Patient presents with generalized abdominal pain and diarrhea. On exam the abdomen is soft with diffuse tenderness.
Chest x-ray: negative
Upper GI: partial obstruction in antrum and pylorus.
Liver scan: no definite focal defects.
CEA: 8.2 (within normal limits)
Gastroscopy: Findings consistent with carcinoma.
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.
Gastric washings and brush biopsy: mucinous adenocarcinoma consistent with gastric origin.
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.
Surgery: Total gastrectomy with regional lymph node dissection.
Chemotherapy recommended as palliative treatment option, patient has not decided whether to undergo treatments.