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CARDIAC GASTRIC CANCER IN A PATIENT WITH A BLADDER NEOPLASM: CASE REPORT

Boryana Georgieva, Irina Ivanova, Milko Mirchev, Nikolay Georgiev

Abstract

Introduction: The incidence of cardiac gastric cancer is increasing with a general tendency of reducing the severity of gastric cancer in the world. The risk factors for cancers of the cardia are also different; the role of genetic factors of Barrett’s esophagus and smoking is being discussed, while Helicobacter pylori infection is established as not being a carcinogen.

Materials and Methods: The aim of this report is to present a case of synchronous development of gastric adenocarcinoma and transitional cell carcinoma of the bladder.

Results: A 71-year-old man was admitted at the Department of Gastroenterology with complaints of progressive loss of appetite and asthenoadynamia, abdominal pain in the left hypochondrium and postprandial epigastric fullness. Recently, the condition has started to present also with dysphagia to solids and quickly after that to liquid foods. The patient has a history of Barrett’s esophagus and moderately differentiated papillary transitional cell carcinoma of the bladder (T1N1M0, G2), managed with surgery and 2 courses of chemotherapy in the summer of 2016. Laboratory tests showed hypochromic microcytic anemia (Hb 108 g/l), a tendency to thrombocytosis and elevated CA 19-9 (4x the upper limit of normal). An abdominal ultrasonography found: gastric wall (high part of the stomach body) - 6 mm, rough and focal bladder wall thickening with polypoid masses. Contrast-enhanced ultrasonography and computed tomography didn`t register liver metastases. During the upper endoscopy a carcinoma of the gastroesophageal junction was established: infiltration near the Z-line of a tumor formation, which causes incomplete obturation, and in retroflexed view was seen an oval tumor formation in cardia, histologically confirmed as highly to moderately differentiated adenocarcinoma. Following a decision of an Oncology Commission, the patient was referred for surgical treatment.

Conclusion: We analyzed the current recommendations for the behavior of cardia carcinoma of the stomach and the gastroesophageal junction and the mechanisms for synchronous development of gastric adenocarcinoma and transitional cell carcinoma of the bladder.


Keywords

gastric adenocarcinoma, gastroesophageal cancer, bladder cancer


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