PMC9483163_01
Preoperative auxiliary examination and postoperative specimen. (A-F), abdominal enhanced CT showed gastric cancer thickening in the gastric antrum, and the tumor was not clearly demarcated from the left lobe of the liver; the size and shape of the liver were normal, the edge was smooth, and no abnormal density and enhancement foci were found in the parenchyma (A-C) shows the arterial phase; (D-F) shows portal venous phase). (G), the distal stomach and part of the left lateral lobe of the liver after the operation.
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Thorax and abdomen plain scan and contrast-enhanced CT ( Figures 1A   -F ) showed gastric cancer thickening in the gastric antrum, considering the tumor, and the tumor was not clearly demarcated from the left lobe of the liver; the size and shape of the liver were normal, the edge was smooth, and no abnormal density and enhancement lesions were found in the parenchyma. After obtaining their consent and signing the informed consent form, we performed radical distal gastrectomy (Billroth II gastrointestinal reconstruction) and partial left lateral lobectomy of the liver ( Figure 1G ).
The tumor tissue expressed broad-spectrum cytokeratin (CKpan), CK-7, and CK-19, but not CK-20, C-erB-2, CD-10, CD-56, synaptophysin (Syn), chromogranin A (CgA).
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A (CgA), and Ki67 proliferative index was approximately 70% ( Figures 2 ). After communicating with pathologists and considering the immunohistochemical results, we considered gastric metastasis from intrahepatic biliary adenocarcinoma.