Occult gastric cancer with distant metastasis proven by random gastric biopsy

Figure 1 A huge heterogeneous enhancing ovarian mass and peritoneal metastatic lesions were observed. A: Computed tomography (CT) scan; B: Positron emission tomography-CT scan.

Figure 2 No grossly abnormal lesion was observed in gastroscopy. A: Examination at first visit to the first hospital; B: At repeat visit to the second hospital; C: At the last visit to our hospital. The black arrows indicate the random biopsy sites. Green matter is remnant gastric content.

Figure 3 Histopathologic findings. A: Lymph node needle biopsy; B: Gastric random biopsy; A and B: Hematoxylin-eosin staining and magnification × 400.