An 81-year-old male with a history of hypertension, diabetes mellitus, chronic renal failure and peripheral arteriopathy.
You have toxic syndrome and gastric dyspepsia
This is an endoscopic study reporting neoformation at the antral juxtapilrical level that hinders placement of the endoscope and the rest of the examination within normal limits.
Biopsy reports adenocarcinoma.
Analytical analysis showed hypochromic anemia and tumor markers within normal limits (ACE: 3.17 μg/l, CA 19.9: 17.31 KU/l).
Abdominal CT scan showed a gastric tumor extending throughout the lesser curvature to the bulb and the first duodenal portion with adjacent lymphadenopathies at the lower margin.
Cholelithiasis.
There are no retroperitoneal lymph nodes or distant metastases.
Surgical intervention was performed, which showed antral neoplasia extended to the gastric body. Cholecystectomy, total gastrectomy and esophagojejunostomy Roux-en-Y were performed.
The anatomopathological study reports two masses of neoplasic aspect, with an ulcero-necrotic center and mamelon margins non-malignant, separated by a gastric wall of normal appearance 53 glandular cell with a diffuse pattern.
This proliferation is located in the gastric wall up to the muscular layer, without reaching the adipose tissue.
It is an adenocarcinoma of intestinal and diffuse pattern.
Resection surgical margins were unaffected.
Adenocarcinoma was found in one of 32 resected lymph nodes without extra extension.
The postoperative course was uneventful.
Evaluated by the oncology committee, adjuvant treatment is rejected due to patient comorbidities.
Controlled in outpatient clinics at 6 months follow a good evolution.
