Multimodal treatment in gastric adenocarcinoma - clinical case

Abstract

Background. Gastric cancer is the 4th most common malignancy worldwide and 2nd leading cause of cancer related death. Highest incidence observed in East Asia, Central Asia, Eastern Europe, and the Pacific Coast of South and Central America. Although the course of multimodal treatment has improved, radical resection is still the current main treatment for gastric cancer. Objective of the study. To document a case of gastric adenocarcinoma, detailing clinical manifestations, diagnostic processes, treatment and outcomes. Material and methods. This case report was prepared with the patient’s consent, utilizing hospital records, test results, and direct discussions with both the patient and the primary doctor. Results. A 70-year-old South Asian male presented with fatigue, unintentional weight loss, and blood in stool. CBC revealed severe microcytic anemia (Hgb 5.3) indicative of iron deficiency. The patient had a history of DVT but no other comorbidities. Upper GI endoscopy unveiled an exophytic growth in the antrum, and biopsy confirmed gastric adenocarcinoma, intestinal type. The patient underwent radical distal gastrectomy with Billroth II anastomosis, followed by 8 cycles of oral chemotherapy with capecitabine. Postoperative PET-CT revealed mild metabolically active nodular omental thickening in the epigastrium, suggesting potential residual involvement which necessitates close follow-up. Conclusion. This case exemplifies the successful management of gastric adenocarcinoma through early diagnosis, timely surgical intervention and chemotherapy, highlighting the importance of vigilant follow-up to address any potential residual disease.