| Physical Exam |
|
Neck: no adenopathy. Abdomen: a 4 x 4 cm firm nodular slightly
tender and movable mass in the epigastric region. Rest of abdomen non-tender.
No mention of lymph nodes. |
| |
|
| Imaging |
2-17-XX
|
UGI: suggestive of carcinoma of the stomach. No size mentioned. |
| 2-19-XX |
Chest: no active disease. |
| |
|
| Laboratory |
2-19-XX |
Alkaline phosphatase: within normal limits. |
| |
|
| Manipulative Procedures |
|
None |
| |
|
| Surgical Observations |
2-21-XX
|
Palliative subtotal gastrectomy: large mass of carcinoma in distal
stomach which seems to stop sharply at the pylorus. Tumor
occupying approximately lower 1/3 of stomach. Umbilicated relatively
good-sized metastasis in dome of liver, probably 4-5 cm in diameter.
Regional nodal metastases and direct extension to the gastric antrum's
adjacent omentum. |
| |
|
| Pathological Reports |
2-21-XX |
Stomach: irregularly shaped fungating lesion measuring
5.0 cm in greatest dimension. At one point erodes through serosa. Tumor
has infiltrated laterally through the pylorus to involve the subserosa
and muscularis of duodenum. Tumor present in lymphatics. Adenocarcinoma,
poorly to moderately differentiated with penetration of serosa, metastases
to lymph nodes of greater and lesser omentum.
|
