Clinical Scenario

A 62-year-old man presents with a 4-month history of epigastric pain, early satiety, and 8 kg weight loss. OGD reveals a large ulcerating mass in the gastric antrum. Biopsy is taken. He proceeds to total gastrectomy and splenectomy. The pathology report shows: signet ring cell carcinoma, positive lymph nodes, positive margins, spleen involved.