UNASSIGNED: Gastric adenocarcinoma, a common advanced-age global malignancy is typically associated with abdominal symptoms. However, atypical presentations such as back pain and respiratory distress particularly in younger patients represent diagnostic challenges. We present a case of a late-30s male who presented initially with back pain, shortness of breath, and constitutional symptoms. A diagnosis of tuberculosis was established presumptively with immediate initiation of treatment. Later on, he presented with abdominal pain and intractable vomiting. Oesophagoduodenoscopy (OGD), tissue histology, and immunohistochemistry confirmed a diffuse type gastric adenocarcinoma. He died as a result of complications from an advanced disease. This particular instance emphasizes the importance of maintaining a high index of skepticism even in atypical presentations, as well as the significance of prompt OGD alongside potential genetic testing if any. Gastric adenocarcinoma should be contemplated by clinicians in a variety of clinical scenarios, especially when handling younger patients from settings with limited resources to facilitate timely diagnosis and effective treatment.
■胃腺癌,常见的高龄全球性恶性肿瘤通常与腹部症状相关.然而,非典型表现,如背痛和呼吸窘迫,特别是在年轻患者中,代表着诊断挑战.我们介绍了一个30多岁的男性,最初出现背部疼痛,呼吸急促,和体质症状。在立即开始治疗的情况下推定确定了结核病的诊断。稍后,他出现腹痛和顽固性呕吐。食管十二指肠镜检查(OGD),组织组织学,免疫组化证实为弥漫型胃腺癌。他死于晚期疾病的并发症。这个特殊的例子强调了即使在非典型的演讲中也要保持高的怀疑指数的重要性,以及提示OGD以及潜在基因检测(如果有的话)的重要性。胃腺癌应该由临床医生在各种临床情况下考虑,特别是在资源有限的环境中处理年轻患者时,以促进及时诊断和有效治疗。