Correspondence to Author: Parveen Malhotra, Rahul Siwach, Pranav Malhotra, Anuj Sharma, Senti, Harman Singh, Sandeep Kumar.. 

Department of Medical Gastroenterology, PGIMS, Rohtak, Haryana and Safdarjung Medical College & VMMC, New Delhi, India.

DOI: 10.52338/jjogastro.2025.5152

Abstract:

Background: Most patients with gastric cancer are symptomatic. Weight loss and persistent abdominal pain are the most common symptoms at initial diagnosis. Approximately 25 percent of patients with gastric cancer have a history of gastric ulcer. Grossly thickened stomach has many differential diagnosis, including both benign and malignant and in latter adenocarcinomas are most common.
Case report: We present a young female of fourty two years, not a known case of any chronic illness, who presented with early satiety, decreased oral intake, vomiting and weight loss for last eight months. All the symptoms were gradually progressive and were not relieved by symptomatic therapy by private practitioner. Her ultrasonogram revealed thickened stomach with suspicious lesion in liver which was confirmed on CT scan abdomen. Her upper gastro-intestinal endoscopy revealed grossly thickened stomach with gastric outlet obstruction and plenty of food residue even after 24 hours fasting. Her first endoscopic biopsy revealed lymphocytic gastritis but in view of strong suspicion, repeat endoscopic biopsy was done which revealed adenocarcinoma. The PET CT revealed malignancy limited mainly to stomach. The surgical oncologist consultation was taken and patient is being worked up for surgery followed by chemotherapy. .
Conclusion:Proper treatment depends on right diagnosis but sometimes atypical presentations or findings of investigations can hinder timely diagnosis which can be countered by repeat testing, as was done in our case by performing repeat endoscopic biopsy of stomach.

Keywords: Endoscopy, Vomiting, Adenocarcinoma, Thickened Stomach, Weight loss.

Citation:

Dr. Parveen Malhotra, Carcinoma Stomach- Atypical Presentation. Japanese Journal of Gastroenterology 2025.