A 55-year-old male presented with upper abdominal bloating followed by modest hematemesis that led to the diagnosis of an ulcerated poorly differentiated (with signet ring cells) @entity420 in the angularis of the stomach. A contrast-enhanced positron emission tomography (PET) with computed tomography (CT) scan showed higher-than-normal physiologic avidity (standardized uptake value, 4.3) in the proximal stomach but not in the lower stomach, and the CT scan vaguely suggested a @entity75 in the distal stomach. Nodes were normal in size, and there were no metastases. He underwent esophagoduodenoscopy with ultrasonography (EUS) that showed a 3- x 2-cm flat nodular mass with an 8-mm ulcer in the angularis. The @entity5 mass was demarcated well on narrow-band imaging, and with a 20-MHz EUS probe, it was designated eusT1bN0. His case was presented to our weekly Multidisciplinary @entity356 Conference, and the consensus was to offer surgery as primary therapy. He underwent a subtotal gastrectomy with Roux-en-Y gastrojejunostomy along with D2 nodal dissection. The surgical pathology showed a poorly differentiated @entity420 with signet ring cells; the @entity5 measured 2.8 x 2.2 cm in diameter with infiltration through the muscularis propria and into the subserosal fat. Seven of 53 examined lymph nodes were malignant; therefore, his @entity5 was staged pT3N3M0 (a higher stage than designated clinically). He recovered well without complications, and the postoperative CT scans showed no metastases. His case was represented at the @entity5 board meeting, and adjuvant chemotherapy with @entity901 and @entity416 was recommended.

Surgical Resection First for Localized XXXX : Are There Adjuvant Options?

@entity901 :: ('MESH:C030110', 'Chemical') :: ['oxaliplatin'] @entity416 :: ('MESH:C110904', 'Chemical') :: ['capecitabine'] @entity75 :: ('MESH:D001927', 'Disease') :: ['polypoid lesion'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'cancer', 'primary tumor'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinoma'] @entity356 :: ('MESH:D013274', 'Disease') :: ['Gastric Adenocarcinoma']
@entity356 :: (MESH:D013274,Disease) :: ['Gastric Adenocarcinoma']
