Tumor BoardsTumor Boards

Gastric adenocarcinoma

Virtual Molecular Tumor Board


Levine Cancer Institute
Presented by: Dr. Jimmy Hwang
Patient: Gastric adenocarcinoma

History


  • Presented in summer of 2015 with back pain, malaise
  • On evaluation, found to have Tbili 6.3, ALT 534, AST 238 (normal in 2014)
  • RUQ U/S showed fatty infiltration, but no masses
  • MRI of abdomen demonstrated intrahepatic, extrahepatic biliary ductal dilatation, with stricture in proximal common bile duct; multiple peripancreatic, celiac, portocaval LN up to 2.6 cm, and lobulated enhancing appearance to proximal stomach wall, measuring up to 5 cm.
  • EGD demonstrated a large, submucosal noncircumferential mass at the GEJ/gastric cardia.
    • Biopsy demonstrated adenocarcinoma, intestinal type
    • HER2 amplified (HER-2: CEP17 ratio of 4.8)
  • PET/CT demonstrated hypermetabolic soft tissue thickening in the GEJ and cardia, measuring up to 40 mm; multiple hypermetabolic pulmonary nodules up to 1.6 cm, and hypermetabolic mediastinal, bilateral hilar, retroperitoneal/paraortic and peripancreatic LN; hypermetabolic 24 mm right adrenal lesion