The diagnosis based on the preceding history, physical examination, laboratory data, endoscopy, imaging studies and pathology is: Recurrent adenocarcinoma of the stomach in a 19 year old Mexican girl.

Consider the following questions about the best management of this patient's problems before proceding:

1. What is the role of each of the following in the etiology of adenocarinoma of the stomach?

a. H. pylori infection

b. inherited genes

c. Epstein-Barr virus

2. Do these etiologic factors apply for cancers occurring in very young people?

---