Diffuse-type gastric cancer in a young adult presenting with neurological symptoms and liver rupture
Tretjak, Z.; Cerar, A.; Pompe-Kirn, V.
American Journal of Gastroenterology 87(8): 1043-1045
1992
ISSN/ISBN: 0002-9270 PMID: 1642208 Document Number: 389922
A 27-yr-old man presented with neurological symptoms and subsequent painful liver enlargement. Cranial computerized tomographic scans and gastroscopy were negative. Ultrasound examination revealed nonhomogeneous echo pattern of the enlarged liver; a guided biopsy specimen suggested hepatoma. The patient died of hemorrhagic shock 5 days after liver biopsy and 4 wk after the initial presentation. Autopsy revealed diffuse-type gastric carcinoma as the primary lesion, liver ruptures at sites distant from the biopsy, thrombosis of the sagittal sinus, and widespread permeation of blood and lymphatic vessels with anaplastic carcinoma cells. The incidence of gastric cancer in young adults from the Cancer Registry of Slovenia is presented for the period from 1979 to 1987. Our case corroborates the importance of considering this malignancy early in the evaluation of young symptomatic patients.