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Diagnostic challenges in gastric adenocarcinoma: a case report

MOJ Clinical & Medical Case Reports
Trudy Hong, Dion Koh, Andrew Gray


Occam’s razor dictates that the simplest diagnosis is usually the correct one. In ascites of unknown origin, the top differentials must include cirrhosis, malignancy and cardiac failure. Investigations such as ascitic fluid cytology and computed tomography can help identify the underlying pathology, however, these investigations do not have perfect specificity and sensitivity. Thus, “normal” investigations cannot be used to completely dismiss important differentials. In a middle-aged patient with no evidence of cirrhosis or cardiac failure, Occam’s razor suggests that a surgeon thoroughly consider and definitively exclude an occult malignancy prior to removing it from the list of differentials.


gastric cancer, malignant ascites, cytology,peritoneal carcinomatosis, paracentesis, abdominal ultrasound, diagnostic dilemma, abdominal computed tomography