Abstract

NERY, Roberto; BATISTA, Thales Paulo  and  CARVALHO, Estela K. B.. Diffuse gastric adenocarcinoma (Lauren classification): exacerbating lymphatic dissemination in young patient. ABCD, arq. bras. cir. dig. [online]. 2007, vol.20, n.1, pp. 59-61. ISSN 0102-6720.  http://dx.doi.org/10.1590/S0102-67202007000100011.

BACKGROUND: Gastric cancer continues to be a significant and relevant oncologic cause of death in the world, with a great majority of western cases being diagnosed in an advanced tumoral phase. Adenocarcinomas represent the totality of cases having a worst prognosis in Laurens' diffuse type, which is more frequent in young patients. CASE REPORT: 20 year-old farmer, admitted with gastric plenitude, abdominal pain, postprandial vomits, with generalized adenomegaly of painless and hardened, becoming more evident due to size in the submandibular and cutaneous epigastric region. Upper digestive endoscopy showed an antral ulcero-infiltrative lesion containing extensive areas of necrosis, which completely obstructed the pyloric region. Abdominal tomography showed an unlimited tumor, extending to the right epigastric hypochondrium, compromising the second portion of the duodenum. Anatomopathologic studies revealed a poorly differentiated adenocarcinoma with signet ring cell pattern. The patient was submitted to palliative gastrojejonostomy. CONCLUSION: Gastric adenocarcinomas may be present with exacerbating lymphnodal and systemic involvement, especially at young age, generating volumous adenomegalies, turning palliative treatment at the time of diagnosis, the only option available.

Keywords : Stomach neoplasms; Adenocarcinoma.