A 76-year-old woman presented to her physician with a four-week history of sporadic chest pressure radiating to her back. An unremarkable extensive evaluation for a cardiac source included a normal stress test and abdominal ultrasound. Later, she developed epigastric abdominal pain. Given the history of prior H. pylori infection, a peptic ulcer was suspected.
A large, ulcerated tumor in the stomach was demonstrated by an upper endoscopy. Pathological examination Biopsy specimens of the stomach ulcer demonstrated moderately to poorly differentiated adenocarcinoma. Staging computed tomography (CT) scans of the pelvis, abdomen and chest showed prominent lymph nodes within the gastrohepatic ligament. Evidence suggested the absence of metastatic disease. Upon evaluation, an intermittent upper abdominal discomfort was reported that was worse when starving but was typically relieved with…
