A woman aged 69 years presented with a 2-week history of left-sided neck swelling, dysphagia and night sweats. CT revealed an internal jugular venous thrombosis, multiple pulmonary emboli and gastric thickening. Endoscopy found a haemorrhagic fundal polypoidal tumour; biopsies diagnosed a gastric adenocarcinoma, Lauren's intestinal type. She was managed with radiotherapy and low molecular weight heparin.
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