case_images: PMC11272450_01
case_images: Enhanced abdominal CT, gastroscopy, and biopsy results upon initial admission. (A) Cancer in the gastric antrum (the yellow arrow); (B) Enlarged lymph node on the lesser curvature side (the yellow arrow); (C) Gastroscopy showing a mass in the gastric antrum (the yellow arrow); (D) Biopsy pathology indicating moderately differentiated adenocarcinoma (the yellow arrow).
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case_images: Contrast-enhanced abdominal CT ( Figures 1A, B ) demonstrated slight thickening of the gastric angle wall, consistent with cT3N1M0 gastric antral cancer. Figure S1 ) scan did not find the matastasis. Following a multidisciplinary team (MDT) discussion, the patient was diagnosed with moderately differentiated adenocarcinoma of the antrum ( Figures 1C, D ), cT3N1M0.
case_images: Enhanced abdominal CT, gastroscopy, and postoperative pathology results after neoadjuvant chemotherapy. (A) The tumor in the gastric antrum has almost disappeared, with a rough gastric wall (the yellow arrow); (B) The enlarged lymph node on the lesser curvature side has disappeared (the yellow arrow); (C) The mass in the gastric antrum has disappeared, with mucosal congestion and edema (the yellow arrow); (D) Postoperative pathology: ypT1aN0M0, tumor nests located in the lamina propria (the yellow arrow).
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case_images: After three cycles of this regimen, contrast-enhanced abdominal CT ( Figures 2A, B ) revealed near-complete resolution of the tumor, with thickening of the gastric antrum wall and no evident enlarged lymph nodes. Gastroscopy ( Figure 2C ) showed resolution of the antral mass with hyperemic and edematous mucosa. The postoperative pathology report ( Figure 2D ) indicated that most of the stomach angle mucosa showed chronic inflammation with numerous lymphocytes and a few foam cells infiltrating. The results of gastroscopy and enhanced abdominal CT are shown in  Supplementary Figure S2 .
case_images: Treatment flow chart (CT, Computerized Tomography, PR, Partial Response, D2, Dissection 2 Lymphadenectomy, pCR, Pathological Complete Response).
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case_images: Figure 3 ). Following the completion of treatment, enhanced abdominal CT indicated a good postoperative condition of the distal stomach, with no significant thickening or abnormal enhancement at the anastomosis, and no evident distant metastasis ( Figures 4A, B ).
case_images: Enhanced abdominal CT, gastroscopy, and biopsy results after completing all treatments. (A, B) Enhanced CT shows edema and thickening at the anastomosis, with no obvious enhancement (the yellow arrow); (C) Gastroscopy showing congestion and edema at the anastomosis, with a rough mucosa (the yellow arrow); (D) Biopsy indicating chronic mucosal inflammation, epithelial hyperplasia, interstitial edema, and no apparent tumor cells in the tissue (the yellow arrow).
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case_images: Figure 3 ). Following the completion of treatment, enhanced abdominal CT indicated a good postoperative condition of the distal stomach, with no significant thickening or abnormal enhancement at the anastomosis, and no evident distant metastasis ( Figures 4A, B ). Gastroscopy and biopsy revealed mucosal edema and thickening at the anastomosis, with a rough surface ( Figure 4C ). The biopsy pathology showed chronic mucosal inflammation, epithelial hyperplasia, and interstitial edema, with no apparent tumor cells ( Figure 4D ).