An 86-years-old male was admitted with a weight loss of 28% in the last 10 months, with a two-month history of anorexia and recurrent postprandial vomiting (2–3/ day). Patient history Four months earlier, he sought medical attention complaining of unspecific abdominal symptoms. The patient’s blood tests, abdominal X-ray, and colonoscopy were all normal. He had a past medical history of type 2 diabetes mellitus, hypertension, and dyslipidemia, under treatment with insulin, candesartan, and simvastatin.
Physical examination was remarkable for cachexia, with a body mass index of 15.7 kg/m2 and a solid, irregular and painless mass in the epigastrium. Blood tests were positive for a normocytic normochromic anemia, γGT 1.5x upper limit of normal and HbA1c of 8%. Chromogranin A value of 1137 ng/mL (reference range <85) Abdomen ultrasound revealed a lobulated heterogeneous mass in the…
