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Case Seventy One - Infiltrating Carcinoma of the Stomach

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Clinical History: The patient is a 74 year old white female who complained of weight loss and early satiety. Her reason for visiting her physician was to accompany her husband during a medical office visit. She was found to have carcinoma of the colon.

Findings: Barium study demonstrated a normal esophagus; however, the superior one-half of the stomach showed fixed gastric walls with shallow irregular filling defects. Air contrast study showed numerous small ulcerations and irregularities. The distal portion of the stomach showed no evidence of abnormality and peristalsis was normal in that region.

Diagnosis: Extensive infiltrating carcinoma of the stomach consistent with Borrmann Type IV carcinoma of the infiltrating variety.

Discussion: CT scan showed no evidence of metastatic disease. Adenocarcinoma and lymphoma were considered as highest probabilities. Subsequent biopsy showed the lesion to be adenocarcinoma.

References:
Alimentary Tract Radiology, Third Edition, Vol. 1, Alexander R. Margulis and
H. Joachim Burhenne, pp. 721-765.

Neoplastic Diseases of the Stomach, Chapter 26, Hikoo Shirakabe and Masakazu Mauruyama.

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Submitted by:
R. J. Alfidi, M.D.