An Unusual and Unfortunate Presentation of a Gastric Adenocarcinoma

Abstract

Gastric adenocarcinoma is the third leading cause of mortality worldwide. Although it is a relatively infrequent neoplasm in North America, it is associated with a high mortality rate. Gastric adenocarcinoma is believed to result from inflammation of gastric cells leading to peptic ulcers which then progresses to cancer. Our case highlights a rare presentation of a rapidly growing gastric adenocarcinoma, originally unseen on endoscopy a month prior, and later appearing as a large circumferential mass. Initially the H. pylori and biopsy results in negative findings for adenocarcinoma, however, a month later the biopsy results were positive for gastric adenocarcinoma. Gastric adenocarcinomas are usually insidious and presents initially as non-specific symptoms such as dyspepsia, nausea, and early satiety. The initial workup consists of an EGD and EUS for localization, tissue biopsy, and determination of tumor size/depth as well as locating regional lymph nodes. Our case highlights the emphasis of frequent surveillance and close follow-up of patients who have increased risk factors for gastric adenocarcinomas as these cancers can often be missed and are fatal.