PMC7490813_01
(1A) PET-CT scan showing a hypermetabolic primary lesion. (1B) PET-CT scan showing a liver nodule on segment III. (1C) CT scan showing the primary lesion before neoadjuvant treatment. (1D) Coronal plane of the same study shown in 1C. (1E) CT scan showing the primary tumor after neoadjuvant chemotherapy. (1F) Same study as 1E showing the coronal plane.
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Positron emission tomography-computed tomography (PET-CT) revealed elevated metabolism in perigastric lymph nodes, as well as a small nodule on hepatic segment III (Fig. 1A-D). On re-staging, a remarkable decrease in volume of both the primary lesion and the secondary hepatic nodule were observed (Fig. 1E, F), motivating surgery with curative intent.
PMC7490813_02
(2A) CT scan showing liver metastases. (2B) Same CT scan showing the primary gastric lesion. (2C) Restaging CT scan showing stable liver metastases. (2D) Same CT scan showing progression of the disease in the primary gastric lesion.
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Abdominal magnetic resonance imaging (MRI) revealed gastric wall thickening in the smaller curvature with infiltration of the adjacent fat tissue measuring up to 8.2 cm, as well as the aforementioned multiple liver nodules (Fig. 2).