title: Gastric adenocarcinoma after gastric bypass for morbid obesity: a case report and review of the literature.
abstract: Gastric adenocarcinoma after gastric bypass for morbid obesity is rare but has been described. The diet restriction, weight loss, and difficult assessment of the bypassed stomach, after this procedure, hinder and delay its diagnosis. We present a 52-year-old man who underwent Roux-en-Y gastric bypass 2 years ago and whose previous upper digestive endoscopy was considered normal. He presented with weight loss, attributed to the procedure, and progressive dysphagia. Upper digestive endoscopy revealed stenosing tumor in gastric pouch whose biopsy showed diffuse-type gastric adenocarcinoma. He underwent total gastrectomy, left lobectomy, distal pancreatectomy and splenectomy, segmental colectomy, and bowel resection with esophagojejunal anastomosis. The histopathological analysis confirmed the presence of gastric cancer. The pathogenesis of gastric pouch adenocarcinoma is discussed with a literature review.
authors.affiliation: Department of Surgery, Digestive Diseases Surgical Unit, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 Cidade Universitária Zeferino Vaz, 13083-887 Campinas, SP, Brazil.
authors.forename: Maxwel Capsy Boga
authors.initials: MC
authors.lastname: Ribeiro
authors.forename: Luiz Roberto
authors.initials: LR
authors.lastname: Lopes
authors.forename: João de Souza
authors.initials: Jde S
authors.lastname: Coelho Neto
authors.forename: Valdir
authors.initials: V
authors.lastname: Tercioti
authors.forename: Nelson Adami
authors.initials: NA
authors.lastname: Andreollo