What happened, in summary

A 45-year-old man sought care for painless enlarged lymph nodes in his neck. Biopsy showed Hodgkin lymphoma, and CT performed during the workup also found thickening along the stomach. Endoscopy revealed a malignant-looking ulcer at the gastric cardia, and biopsy confirmed gastric adenocarcinoma. The gastric tumor was HER2 IHC 0.

He underwent total gastrectomy with Roux-en-Y esophagojejunostomy. Surgical pathology showed poorly differentiated gastric adenocarcinoma classified as Stage II. Ten days after surgery, he started postoperative S-1 chemotherapy for the gastric cancer. Because he developed troublesome itching and skin pigmentation, S-1 was stopped and the gastric treatment was changed to capecitabine. He ultimately completed 4 cycles of capecitabine while receiving separate treatment for Hodgkin lymphoma.

Follow-up imaging after completion of the combined treatment plan mainly assessed his lymphoma-related lymph nodes. He had no discomfort, and routine follow-up was continuing as of November 2016.