What happened, in summary

A 63-year-old woman had persistent indigestion despite treatment for Helicobacter pylori and lost about 14 kg over 2 months. Endoscopy showed a 4 cm pyloric ulcer with marked narrowing of the gastric outlet. Biopsy identified adenocarcinoma with signet-ring cells.

During staging, CT unexpectedly found a large tumor in the left kidney, with no distant metastases seen. She therefore had two separate primary cancers at the same time: gastric cancer and renal-cell carcinoma. Both were addressed in one operation. A partial gastrectomy with gastrojejunal reconstruction was performed for the stomach tumor, while a left radical nephrectomy treated the kidney cancer. Her postoperative course was uncomplicated.

Pathology of the stomach showed poorly differentiated diffuse-type adenocarcinoma with signet-ring cells, without regional lymph-node or distant spread identified for the gastric cancer. The kidney tumor was a separate clear-cell renal-cell carcinoma treated during the same operation.

She remained under active surveillance with monthly surgical and oncology follow-up. CT imaging and laboratory studies showed no evidence of gastric-cancer relapse or distant metastases, supporting a current no-evidence-of-disease status.