Successful Palliative Radiotherapy for Malignant Cardiac Obstruction Caused by Gastric Cancer.

Area of Science:

• Oncology
• Gastroenterology
• Radiotherapy

Background:

• Advanced gastric cancer presents challenges, often diagnosed at unresectable stages.
• Palliative radiotherapy (RT) offers symptom relief but typically has limited duration of efficacy.
• Malignant cardiac obstruction is a severe complication of advanced gastric cancer.

Observation:

• A 78-year-old female patient with stage IV poorly differentiated adenocarcinoma of the stomach presented with anorexia and severe anemia.
• Esophagogastroduodenoscopy revealed a giant gastric tumor causing malignant cardiac obstruction.
• The patient opted for palliative care, and palliative RT was administered to alleviate the obstruction.

Findings:

• Palliative radiotherapy led to significant reduction of the 4 cm gastric tumor.
• The malignant cardiac obstruction resolved completely following RT.
• The patient experienced no obstruction symptoms for three years post-treatment, indicating long-term efficacy.

Implications:

• This case suggests that palliative RT can provide durable symptom control for malignant cardiac obstruction in gastric cancer.
• The long-term efficacy observed may be linked to the poorly differentiated histological type, known for radiosensitivity.
• Radiotherapy should be considered as a valuable palliative option for specific gastric cancer presentations, particularly those with poorly differentiated histology.