PMC5346926_01
Esophagogastroduodenoscopy showing Borrmann type 3 gastric cancer at the antrum of the stomach.
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Esophagogastroduodenoscopy showed Borrmann type 3 advanced gastric cancer located at the gastric antrum (Fig. 1).
Three-dimensional computed tomography of the stomach showing an ulceroinfiltrative gastric lesion in the mid to lower body along the lesser curvature with perigastric infiltration, which was diagnosed as T3 advanced gastric cancer.
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An abdominal three-dimensional computed tomography (CT) scan (Fig. 2) and 18F-fluorodeoxyglucose positron emission tomography-CT (FDG-PET-CT) scan (Fig. 3) revealed an ulceroinfiltrative gastric lesion in the mid to lower body along the lesser curvature and multiple enlarged conglomerated metastatic lymph nodes in the perigastric, gastrohepatic ligament, and the splenic hilum, and retropancreatic, portocaval, and aortocaval portions were noted.
Abdominopelvic computed tomography scan after 2 cycles of chemotherapy showing an interval-improved ulceroinfiltrative gastric lesion and marked regression of multiple enlarged conglomerated metastatic lymph nodes in the perigastric, gastrophepatic, splenic hilum, retropancreatic, porta hepatis, portocaval, and aortocaval portions.
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An abdominopelvic CT scan taken after 2 cycles of systemic chemotherapy showed an improving ulceroinfiltrative gastric lesion and marked regression of multiple enlarged conglomerated metastatic lymph nodes in the perigastric, gastrophepatic, splenic hilum, retropancreatic, porta hepatis, portocaval, and aortocaval portions (Fig. 4).
F-18fluorodeoxyglucose positron emission tomography-computed tomography scan taken 12 months after the operation showing the disappearance of preoperatively noted left gastric, splenic hilum, left para-aortic, aortocaval, and retrocaval lymph nodes.
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A PET-CT scan taken 12 months after the operation showed no definite evidence of local recurrence or distant metastasis and the disappearance of previously noted retroperitoneal lymph nodes (Fig. 5).
Positron emission tomography-computed tomography scan taken 16 months after the operation showing multiple lymph node metastasis, including the left supraclavicular, paratracheal, para-aortic, retrocaval areas as well as a bone metastasis in both femurs, the sacrum, lumbar 4th and 5th vertebrae, and the left 6th rib.
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A FDG-PET-CT scan taken 16 months after the operation showed multiple lymph node metastases, including those in the left supraclavicular, paratracheal, para-aortic, and retrocaval areas, as well as bone metastases in both femurs, the sacrum, lumbar vertebrae 4 and 5, and the left sixth rib (Fig. 6).