Patient 66 years old, male, with morbid history of hypertension and type 2 diabetes mellitus (DM) under treatment.
She was admitted to the surgery service of the Hospital Base de Los Angeles for a 4-month clinical picture characterized by asthenia, adynamia, sudden epigastric burning, heartburn and pruritic lesions, associated with feet.
Physical examination revealed a patient in good general condition, in which only the presence of seborrheic, seborrheic and hyperpigmented lesions stood out in both feet, associated with a clinical history suggestive of
1.
Due to suspicion of neoplasia of the digestive tract study was initiated, laboratory tests showed no alterations, upper endoscopy was performed concluding the presence of ulcerated lesion gastric body, which was biopsied and H pylori test with positive result for urease.
Subsequently, a biopsy report concluded a lesion of morphological aspect compatible with gastric mucosal fragment caused by moderately differentiated adenocarcinoma with signs of active ulceration.
1.
For this reason, a preoperative and dissemination study was initiated in which a computerized axial tomography (CAT) of the abdomen and pelvis was requested, showing no macroscopic distant disease or lymphadenopathy, multi-abdominal computed tomography (Angiogram).
Because the dissemination study did not show metastatic compromise and had operability criteria, treatment was decided with curative intent, performing extended total gastrectomy plus cholecystectomy by the team of Digestive Surgery Los Átageles Hospital.
Subsequently, the patient was discharged, attending serial controls at the hospital polyclinic.
The last control was shortly before writing this communication, presenting a favorable evolution with disappearance of cutaneous manifestations.
