Abstrakt: |
Synchronous gastric tumors, and, especially the presence of an adenocarcinoma and gastrointestinal stromal tumors, are less frequent. We present the case of a 75-year-old patient, with no gastrointestinal pathology in the medical history, who was admitted for marked asthenia, nausea, coffee grounds vomiting, inappetence, dizziness, weight loss and periodical epigastralgias. The clinical and imagistic examinations highlighted an ulcerative, infiltrative, bleeding tumor formation, present on the anterior side and subcardially on the small curvature. During the surgery, there was highlighted a second tumor, whitish, of about 2.5 cm, prominent under the peritoneal serous, of firm consistency and with an adherence to the stomach muscles. For removing the two tumors, there was performed total gastrectomy with esophagus-jejunal termino-lateral anastomosis, with jejunum ansa "in omega". The histopathological and immunohistochemical examinations established that the first tumor was a poorly differentiated carcinoma, and the second was a gastrointestinal stromal tumor. The patient's evolution was a good one, both clinically and biologically, the imagistic examinations performed after six and 12 months highlighting the lack of local relapses and absence of metastases. |