Gastric Adenocarcinoma in a young Nigerian - A Case Report
Abstract
Abstract
Gastric adenocarcinoma is uncommon among young Nigerians. We present Mrs O.V. a 41year old Nigerian who presented with one year history of recurrent epigastric pain that was peppery/burning in nature, non-radiating, aggravated by eating and temporarily relieved with the use of antacids. There is associated progressive weight loss and secondary amenorrhea since the onset of her illness. She started vomiting two weeks prior to presentation which was non-projectile, containing both recently ingested meals and partially digested stale food substances, vomitus was non-bilous. Episodes of vomiting is usually preceded by abdominal bloating or feeling of indigestion. Clinical examination revealed a chronically ill-looking young woman with a positive succussion splash on abdominal examination. Examination of the other systems was normal. Provisional diagnosis was suspected Chronic Gastric Antral Ulcer complicated by Gastric Outlet Obstruction to rule out Gastric Antral Adenocarcinoma. Abdominal ultrasound and CT scans showed features consistent with Gastric Outlet Obstruction. Upper GI Endoscopy revealed Gastric Antral Adenocarcinoma with Duodenal extension and Chronic Duodenal Ulcer complicated by Gastric Outlet Obstruction. Histology showed well differentiated Gastric Antral Adenocarcinoma. She had a Bilroth II procedure(Partial Gastrectomy and Gastro-Jejunostomy)and was commenced on adjunct chemotherapy: FAM regimen(5-Fluorouracil, Adriamycin and Mitomycin). She was also placed on long term proton pump inhibitor therapy. She has sustained remarkable clinical improvement with resolution of all her initial symptoms and she is currently on regular clinic follow-up. More cases of Gastric Adenocarcinoma among young Nigerians are being reported. There is a need for more extensive studies on this and possibly an indication for commencing endoscopy screening at an earlier age among individuals presenting with recent onset dyspepsia.
Key words: Gastric, Adenocarcinoma, Young, Nigerians.
References
References
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov. 68 (6):394-424.
World Health Organization. Cancer. WHO. Available at http://www.who.int/mediacentre/factsheets/fs297/en/. 12 September 2018; Accessed: February 5, 2020.
Stock M, Otto F. Gene deregulation in gastric cancer. Gene. 2005;360(1):1–19.
Parkin DM. Global cancer statistics in the year 2000. Lancet Oncol. 2001;2:533–543.
Oluwasola AO, Ogunbiyi JO. Gastric cancer: aetiological, clinicopathological and management pattern in Nigeria. Niger J Med. 2003;12:177–186.
Sitarz R, Skieruchab M, Mielko J, Offerhaus G, Maciejewski R, Polkowski W. Gastric cancer: epidemiology, prevention, classification, and treatment. Cancer Manag Res. 2018; 10: 239–248.
Forman D, Burley VJ. Gastric cancer: global pattern of the disease and an overview of environmental risk factors. Best Pract Res Clin Gastroenterol. 2006;20(4):633–649.
Surveillance, Epidemiology, and End Results Program. SEER Stat Fact Sheets: Stomach Cancer. National Cancer Institute. Available at http://seer.cancer.gov/statfacts/html/stomach.html. Accessed: February 5, 2020.
Bakari AA, Ibrahim AG, Gali BM, Dogo D, Ngadda HA. Pattern of gastric cancer in Northeastern Nigeria: A clinicopathological study. J Chinese Med. 2010;5:211–215.
Afuwape OO, Irabor DO, Ladipo JK, Ayandipo B. A review of the current profile of gastric cancer presentation in the university college hospital Ibadan, a tertiary health care institution in the tropics. J Gastrointest Cancer. 2012;43(2):177-180.
Abdulkareem FB, Onyekwere CA, Awolola NA, Ajekigbe AT. Clinico-pathological review of malignant gastric tumours in Lagos, Nigeria. Nig Q J Hosp Med. 2010;20(2):49-54.
Cabebe EC. Gastric Cancer. https://emedicine.medscape.com/article/278744-overview#a1 Updated: Feb 24, 2020. Accessed: Feb 27,2020.
Shaukat A, Wang A, Acosta RD, et al. The role of endoscopy in dyspepsia. Gastrointestinal Endoscopy 2015;82(2):227-232.
Ahmed A, Ukwenya AY, Makama JG, Mohammad I. Management and outcome of gastric carcinoma in Zaria, Nigeria. Afr Health Sci. 2011;11(3):353-361.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution 3.0 License.