Patient Medical Report

PLANNED FOR PERI-OPERATIVE CTX FLOT FOR CYCLE 1 FLOT EVALUATED BY CARDIOLOGY TEAM IN 10 FEB\2026 CONCOR WAS INCREASED TO 7,5 MG then re-evaluated by cardiology no contraindications to use s-fe as the pt i on rate control concor pt was given FOT CYCLE 1 ANT THE END OF THE 5-FU INFUSION PT DEVELOPPED SVT IT WAS NOT CONTROLLED BY ADENOSINE NOR LOPRESSOR PT WAS TRANFERRED TO ICU AND STARTED ON AMIODARONE WHICH WAS STOPPED LAST Night BECUASE OF BRADYCARDIA

First cycle of FLOT

Post total gastrectomy

Findings Under video-fluroscopic guidance the patient swallowed low-osmolar contrast media: The contrast passed to the ileum. No evidence of leak. The procedure ended without any complications and the patient sent back to his primary health care provider.

No GOO No leak

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For gastric malignancy absolute diagnosis

ENDOSCOPY 18-6-2026 FINDINGS: Esophagus: NORMAL LOOKING MUCOSA Stomach : JUST BELOW THE GE JUNCTION AT THE LESSER CURVATURE SIDE THERE IS A SUPERFICIAL ULCER WITH FRIABLE SURROUNDING MUCOSA, ABOUT 1 CM IN DIAMETER. BX TAKEN Duodenum : NORMAL UP TO DII

Gastric biopsy 21/6/2026: Invasive moderately differentiated adenocarcinoma

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For gastric ca staging

Abdomen CT scan with IV contrast: No significant changes regarding the previous mentioned multiple abnormally enlarged perigastric lymph nodes noted medial to the lesser curvature, the largest measures 2.4 cm x 1.7 cm no focal liver lesion. No intrahepatic biliary dilatation. Gallbladder appears unremarkable. Spleen, pancreas, both kidneys, adrenal glands appear grossly normal apart from multiple left renal low attenuation cortical cysts. Lower GI tract appear unremarkable. No intra-abdominal or pelvic free fluid. No significant para-aortic lymph node enlargement.

Same as previously enlarged peri gastric lymph nodes Multiple left renal low attenuation cortical cysts

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For gastric ca staging

Chest CT scan with IV contrast: Compared with the previous study dated on11/2 No pneumonic consolidation. No pleural effusion. No suspicious appearing pulmonary masses or significant nodules. No significant mediastinal or hilar lymph node enlargement. Great Multiple old mild malaligned right rib fractures noted. vessels he structures appear unremarkable. Right lower lung lobe atelectatic bands noted. Bilateral axillary lymph node enlargement noted the largest measures 12 mm in short axis seen in the left side.

Bilateral axillary lymph nodes enlargement

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Suspected Gastric ca

Abdomen CT scan with IV contrast: There are multiple abnormally enlarged perigastric lymph nodes noted medial to the lesser curvature, the largest measures 2.4 cm x 1.7 cm further assessment is highly advised to rule out gastric malignancy. No focal liver lesion. No intrahepatic biliary dilatation. Gallbladder appears unremarkable. Spleen, pancreas, both kidneys, adrenal glands appear grossly normal apart from multiple left renal low attenuation cortical cysts. Lower GI tract appear unremarkable. No intra-abdominal or pelvic free fluid. No significant para-aortic lymph node enlargement.

Multiple enlarged peri gastric lymph nodes Endoscopy is recommended for further evaluation

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For another adjuvant 4 cycles of FLOT after wound healing • follow up iliac Lymph nodes to R/O enlargement

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