PMC6800939_01
(a) CT demonstrating gastric mass in the lesser curvature (arrow) with diffuse hepatic metastases. (b) PET scan with 6.5 cm hypermetabolic gastric (Arrow) and no additional sources for a primary tumor. Diffuse hepatic metastases again noted.
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fig1
CT of the abdomen and pelvis with IV contrast revealed a 6.1 cm mass lesion in the lesser curvature of the stomach contiguous with the gastrohepatic ligament, as well as extensive hepatic metastatic lesions, with the largest measuring 9.5 cm (Figure 1(a)). The liver metastasis was appreciated once again, as well as hypermetabolic metastatic adenopathy in the abdomen (Figure 1(b)).
EGD showing retroflex view of GE junction with mass extending from lesser curvature to the cardia with clear demarcation in right lower corner (Arrow), not involving the esophagus.
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fig2
Upper endoscopy revealed a large necrotic mass of approximately 6 cm in the lesser curvature with ulceration in the gastric cardia without extension into the esophagus (Figure 2).
(a) Numerous mitotic figures as well as high grade morphology cells with eosinophilic cytoplasm. (b) P40 Positivity proving squamous differentiation.
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Brisk mitotic activity was noted with focal necrosis, as well as a small focus of keratinization (Figure 3(a)). Immunohistochemical (IHC) stains showed neoplastic cells positive for pancytokeratin including CK7 and CK20, as well as p63 and p40 (Figure 3(b)). Pathological diagnosis was made for invasive poorly differentiated squamous cell carcinoma with rare keratinization (Figure 3(a)).