Gastric Cancer in Chest Radiograph
A 90-year-old man presented with a 1-month history of progressive edema in both legs and several episodes of malaise and dizziness that were associated with hypoglycemia. On examination, a nontender epigastric mass was palpated. A plain radiograph of the chest showed a round, irregular opacity inside the gastric chamber and a colonic segment below the right hemidiaphragm (Panel A). Upper gastrointestinal endoscopy revealed a diffusely eroded, exophytic mass arising from the subcardial area (Panel B). Histologic features were consistent with a high-grade, poorly differentiated gastric adenocarcinoma. The patient received a diagnosis of advanced gastric cancer; he was given treatment to alleviate his symptoms and died 5 months later.