Iranian Journal of Surgery

A Case Report of Liver Metastasis as the First Manifestation of Gastric Adenocarcinoma

Authors

K Hatampour 1
R Shadidi Asil 1
A Zamani 1
SH Mirhashemi 2
M Souri 1
F Rashnow 1
B Oshidori 1
S Mahmoudi 1
E Hajinasrollah 3

1 Assistant Professor, Department of General Surgery, Shahid Beheshti University of Medical Sciences, Loghman Hakim Educational and Medical Center

2 Associate Professor, Department of General Surgery, Shahid Beheshti University of Medical Sciences, Loghman Hakim Educational and Medical Center

3 Professor of General Surgery, Shahid Beheshti University of Medical Sciences and Health Services, Loghman Hospital, Tehran, Iran

Abstract
Introduction & Objective: Early detection plays a vital role in improving the outcomes of patients with gastric cancer. However, identifying the disease during its early stages is challenging due to the lack of specific symptoms. Presentation of Case: This case report presents a patient with gastric cancer and liver metastasis who remained asymptomatic despite the advanced disease. The patient initially presented with acute abdominal right upper quadrant pain, leading to various diagnostic investigations, including ultrasound, CT scan, MRI, and upper gastrointestinal endoscopy. The imaging and pathological findings confirmed the presence of a metastatic liver mass and a large fungating mass in the stomach with the pathology of an adenocarcinoma after endoscopic biopsy. Surgical intervention was avoided due to distant metastasis. The patient underwent FOLFOX (folinic acid, fluorouracil and oxaliplatin) chemotherapy regimen. Results: This case highlights the importance of considering gastric cancer in the differential diagnosis of patients presenting with unexplained abdominal pain without typical symptoms. Conclusions: A multidisciplinary approach involving various medical specialties is necessary to ensure early diagnosis and appropriate treatment for metastatic gastric cancer.

Keywords

Gastric Cancer
Liver Metastasis
Asymptomatic Presentation
Early Diagnosis
Case Report
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Iranian Journal of Surgery
Volume 31, Winter
Winter 2024
Pages 67-73

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