Presentation
Epigastric pain and weight loss.
Patient Data
Irregular mural thickening along the lesser curvature of the gastric body, adjoining part of the fundus and reaching the esophagogastric junction, displaying heterogeneous matrix; enhancing soft tissue with hypodense areas. It measures around 2.9 cm in its maximum thickness. It is encroaching upon the retro-gastric fat, abutting the left lobe of the liver and ventral surface of the pancreatic body with no CT evidence of invasion.
Shotty left gastric adenopathy.
Bilateral adnexal complex masses with heterogeneous enhancement, measuring 5.6 x 5.3 x 5.1 cm and 3.4 x 4.4 x 4.2 cm on the right and left sides respectively.
Marked spondylodegenerative changes in the spine.
Endoscopic biopsy
Clinical data: ulcerating lesser curvature neoplastic lesion.
Gross: Tiny endoscopic pieces.
Microscopic examination: malignant mucin secreting tumor consisting of groups of spheroidal pleomorphic cells, as well as many signet ring cells exhibiting evident cytoplasmic vacuolation, and infiltrating the underlying stroma. There are foci showing extracellular mucin with necrosis.
Conclusion: Gastric mass endoscopic biopsy - gastric mucoid adenocarcinoma G3, signet ring type.
Case Discussion
This case shows gastric adenocarcinoma presenting with gastric mural thickening, coupled with ovarian deposits (Krukenberg tumor).
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