A 90-year-old man presented with a 1-month history of progressive edema in both of his legs, malaise, and dizziness associated with hypoglycemia. His chest radiograph demonstrated abnormal findings. What is the diagnosis? Gastric bezoar Gastric polyp Pyloric stenosis Gastric cancer Peptic ulcer disease
The correct answer is gastric cancer. The chest radiograph demonstrates a round, irregular opacity inside the gastric chamber and a colonic segment over the right hemidiaphragm. This patient underwent an upper gastrointestinal endoscopy which revealed a diffusely eroded, exophytic mass arising from the subcardial area. Histologic features were consistent with high-grade poorly differentiated gastric adenocarcinoma