A male with disseminated ? Ca Stomach

A male aged 45 years Chief Complaints Diagnosed as having Stomach thickening s/o Ca Stomach with generalised Body weakness and diffuse backache underwent PET-CT Diagnosis What is the impression of these images

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based on these images 1) The stomach does appear thick 2)PET FDG uptake does not correlate with any CT structure. However a)Linitis plastica (stomach Ca with thickening) with may not light up on a PET/CT and b)peritoneal metastasis common in stomach Ca usually do not show up on a PET/CT Recommendation EUS assisted endoscopy. Do not do bling biopsies in patient suspicious of linitis plastica, as bling biopsy can often miss the underlying tumor.

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Metastatic peripancreatic lymphadenopathy Infiltrates in head of pancreas Some uptake in vertebrae as well All suggest metastatic ca stomach

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