Introduction: Stomach cancer is one of the most common tumors, often detected in later stages as patients remain asymptomatic until later stages with black stools, accompanied by bodily weakness. Pernicious anemia. a known cause of vitamin B12 deficiency is a classic risk factor for stomach cancer. Patients with PA usually present with megaloblastic anemia and peripheral neuropathy; however, they may also present with nonspecific symptoms, such as gastrointestinal hemorrhage with hemodynamic changes. A 73-year-old man presents in the emergency room of the hospital in Lushnja, Albania, with abdominal pain, and black stools, accompanied by bodily weakness. Complaints have started for several weeks, and the pain is constantly aggravated until it forced him to appear in the emergency department of Lushnja Hospital. The patient complains of a burning sensation in the chest, decreased appetite, physical weakness, and has lost weight 14 kg in the last 3 months, accompanied by nervous disorders. Up to the moment of hospitalization did not refer to nausea, vomiting, or dysphagia, without a history of gastrointestinal disease. Initial laboratory work revealed severe B12 deficiency, and pancytopenia, by the endoscope that revealed a mass of gastric fundus important for adenocarcinoma on biopsy.

Conclusions: Stomach cancer remains one of the most common malignant tumors in the world and usually has a poor prognosis. This is related to the fact that patients are asymptomatic up to advanced stages. Detecting data from physical examination and linking it to laboratory tests may be the first step in the early detection of stomach cancer. In advanced cases, as in the above case, it is important to perform imaging examinations and Esophagogastroduodenoscopy (EGD). Unfortunately, therapeutic solutions in some patients are related to the stage of the disease and the time of diagnosis.

Keywords: Pernicious anemia, melena, total gastrectomy, pulmonary embolism