case_images: PMC10953106_01
case_images: EGD which revealed an infiltrative and ulcerated bleeding mass with malignant appearance at the incisura (the lesser curvature of stomach near pylorus).
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case_images: He underwent esophagogastroduodenoscopy (EGD) which revealed an infiltrative and ulcerated bleeding mass with malignant appearance at the incisura (the lesser curvature of stomach near pylorus) (Figure 1).
case_images: Initial staging CT of the chest, abdomen, and pelvis showed peritoneal carcinomatosis.
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case_images: Staging CT of the chest, abdomen, and pelvis showed peritoneal carcinomatosis (Figure 2).
case_images: Germline genetic testing by Invitae showing a pathogenic mutation of the ATM gene.
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case_images: In light of the patient's family history of gastric cancer, he underwent germline mutation testing by Invitae which was positive for an ATM c6415G>T heterozygous pathogenic mutation (Figure 3).
case_images: Trends of CEA and CA 19-9 from the initial diagnosis to recent follow-up.
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case_images: The patient continued to have a great response until December 2023 (Figure 4).
case_images: Surveillance EGD showed normal gastric mucosa and disappearance of the previously seen tumor.
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case_images: Random biopsy tissue was negative for malignancy (Figure 5).
case_images: After 1 year (1/2023-1/2024) on olaparib monotherapy, there is a mild recurrence of nodular and ground-glass opacity peritoneal metastases on PET/CT, and CA19-9 increased from 13 to 45 units/mL.
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case_images: A subsequent restaging positron emission tomography/computed tomography (PET/CT) scan showed multiple fluorodeoxyglucose (FDG)-avid peritoneal nodules consistent with carcinomatosis and linear increased FDG uptake in a portion of right pleural thickening that was suspicious for cancer involvement (Figure 6).