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Assign Clinical and Pathological Classifications Patient presents with abdominal discomfort, bloating, nausea, and early satiety 02/22/2023 EGD demonstrates ulcerating non-bleeding mass at greater curvature of the stomach, bx reveals poorly differentiated adenocarcinoma. 02/25/2023 endoscopic ultrasound (EUS) demonstrates hypoechoic, circumferential mass in greater curvature of stomach measuring 6.1 cm with irregular borders with invasion into muscularis propria. Two pathologically enlarged left gastric and two enlarged right paracardial lymph nodes measuring at least 1.8 cm by endosonographic criteria. Treatment plan discussed with the patient which will include 4 cycles of chemotherapy & immunotherapy followed by gastrectomy. Following 4 cycles of chemo-immunotherapy the patient was taken to the OR for planned partial gastrectomy. There was residual adenocarcinoma, poorly differentiated, with decrease in size of the tumor, now measuring 1.6 cm. Tumor invaded muscularis propria. All surgical margins were negative for invasive carcinoma. A total of 3/16 perigastric lymph nodes resected positive for metastases.
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