65 year old gentleman came to the OPD with a diagnosis of acute calculus cholecystitis for cholecystectomy. However on proper history taking, patient was having anorexia, weight loss and tobacco addiction apart from other abdominal complaints. On examination there was significant pallor. Prior investigations showed significant unexplained anemia. In view of this a PET CT was performed. It showed a tumor in pyloroantral region. Endoscopy confirmed an ulceroproliferative lesion in antropyloric region & biopsy proved moderate to poorly differentiated adenocarcinoma. Patient underwent a laparoscopic radical gastrectomy with lymph node clearance and cholecystectomy. He recovered uneventfully and was discharged on 6th day. Histopathology showed complete clearance of gastric cancer with spread to few lymph nodes. Hence he is started on adjuvant chemotherapy.

Points to remember

• 1. Do not treat the report, treat the patient.
• 2. Laparoscopic radical gastrectomy is the state of the art surgery for gastric cancer.

For more information on gastric cancer, meet
Dr D R Kulkarni
Consultant GI & HPB Surgeon, Mumbai
Chairman:
Liver & Pancreas Clinic (LPC) Mumbai
Center for Digestive Surgery (CDS) Mumbai