is a gastric cancer of well-differentiated neuroendocrine cells associated with endocrine cell hyperplasia.
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
An 80-year-old Korean man comes to the office because of abdominal pain, weight loss, and early satiety. He says that he has been experiencing some discomfort in the mid-epigastrium. The pain started approximately a year ago, but he thought it was acid indigestion so he took a proton pump-inhibitor which alleviated his pain. The pain has since worsened and he is now experiencing dysphagia. He has lost 9.1-kg (20-lb) over the past 6 months, is easily fatigued, and unable to perform daily tasks around the house. He has a history of coronary artery disease and hypertension. Physical examination shows tenderness to deep palpation in the mid-epigastrium as well as cachexia. Laboratory findings include anemia with a hemoglobin of 8.0 g/dL and hematocrit of 24% with a mean corpuscular volume of 70 fL. A fecal occult blood test is positive. Which of the following is the most likely diagnosis?