Summary of medical history: The patient, a 55-year-old male, presented with epigastric discomfort in January 2009 and felt a feeling of fullness in the epigastrium without belching or acid reflux, and without nausea or vomiting. No attention was paid to it, and then the symptoms gradually worsened. On June 22, 2009, he came to the local hospital for ultrasound examination, which showed a hypoechoic mass in the right lobe of the liver, ascites, and enlarged abdominal lymph nodes. CT of the upper abdomen showed an occupancy in the right lobe of the liver, which was considered to be cancerous, and gastroscopy showed an occupancy in the stomach and an occupancy in the bulb of the duodenum. Pathological biopsy: grade I-II adenocarcinoma of gastric body and grade II-III adenocarcinoma of duodenal bulb. Elevated tumor markers: AFP 186.8ug/L, CEA 37.3ug/L, CA199 153.7KU/L CT chest and abdomen (2009-06-29): 1. thickening of stomach wall, considering gastric cancer with medical history; 2. 6.4*6.3CM hypointense shadow in the right lobe of liver, considering metastatic lesion in the right lobe of liver and possible abdominal lymph node metastasis. Treatment history: Chemotherapy 2009-07-03: systemic chemotherapy (cisplatin 80mg/m2+Hiroda 1000mg/m2), bid d1-14 repeated every 3 weeks. After 2 cycles of chemotherapy, tumor markers decreased to normal levels: AFP 7.1ug/L, CEA 4.29μg/L, CA-199 26.9KU/L CT of whole abdomen (2009-08-21): hypointense shadow in the right lobe of liver was significantly smaller than before (2.5X2.9cm). The tumor markers: AFP, CEA, CA199 were all within normal range on chest + whole abdomen CT (2009-11-23): 1, no obvious metastases in the lung after chemotherapy for liver metastasis of gastric cancer; 2, 17.7×22.5mm hypointense shadow in the right posterior lobe of liver (continued to shrink). Surgery After discussion with the surgeon and imaging physician, the decision was made to perform a major gastrectomy + hepatic mass resection on 2009-12-07. Postoperative pathological examination: (stomach) chronic ulcer with granulomatous tissue proliferation and massive chronic inflammatory cell infiltration, 9 perigastric lymph nodes with large necrosis with histiocytic reaction. (Liver) Infiltrative or metastatic adenocarcinoma was seen in the liver tissue, and necrosis with histiocytic reaction was seen in the liver parenchyma. Follow-up treatment and follow-up Oral chemotherapy drugs for 3 months and adjuvant antitumor therapy with Chinese medicine Follow-up review (times/3 months): 3 tumor marker tests were in normal range Whole abdominal CT: 3 times showed postoperative changes of gastric cancer; postoperative changes of metastases in the right lobe of liver, no abnormal metastatic lesions were seen. By March 2011, the reexamination showed: tumor markers were mildly elevated and whole abdominal CT: an enlarged lymph node appeared in retroperitoneum. Local targeted radiation therapy + chemotherapy + adjuvant therapy with Chinese medicine was adopted. At present, the patient’s disease is slowly progressing, but generally stable.