That dyspepsia in the young could be cancer
A 29-year-old male farmer presented with 4 months history of epigastric pain associated with recurrent vomiting, anorexia, early satiety and weight loss. He also had haematemesis and melaena. He had a history of ingestion of alcoholic beverages and ingestion of smoked food, there was no history of cigarette smoking and no family history of GI malignancy.\nPhysical examination revealed a chronically ill looking pale young man, but had no palpably enlarged peripheral lymph nodes. Abdominal examination revealed epigastric tenderness, and a digital rectal examination revealed melaena stool. Upper GI endoscopy showed a dilated stomach with huge friable mass with necrotic surface, seen at the antral area of the stomach with distortion of the local anatomy []. Histological examination of the biopsy specimen showed a poorly differentiated adenocarcinoma of the gastric mucosa infiltrating and dissecting the muscularis propria; there was no evidence of H. pylori in the biopsy sample []. He had a partial gastrectomy, and is presently on chemotherapy. He is being followed up in the clinic.