Gastric Carcinoma 4
Tumor spread
The tumor can be
metastasized by
four ways;
Regional and distant LNs
The most common
and the earliest
LN Mets may involve
the
supraclavicular lymph
node (Virchow’s node)
Distant metastasis
can also go to
distant organs and most commonly it prefers to go to the
liver via vascular
dissemination
(mainly to liver)
- Direct spread
through the
wall into the
serosa
- Intraperitoneal
spread
very common in the gastric carcinomas especially in
the diffuse type
also can undergo distant metastasis via the peritoneum NOT via
the vascular channels
In females it may involve both ovaries (Krukenberg tumor)
Clinical Features
Early gastric cancer:
. Abdominal discomfor
dyspepsia
Usually asymptomatic
nausea
Advanced carcinoma:
Iron deficiency anemia
(secondary to the chronic blood
loss of the ulceration), anorexia
, bleeding, weight loss
-Tumors of the cardia
may have dysphagia
because of the
anatomical location,
because the cardia is
going to be reflected
on the esophagus and
the integrity of the
lower esophageal sphincter
dysphagia can be secondary because the
underlying pathogenesis of cardial gastric tumors is related to GERD, and its
complications such as intestinal metaplasia and Barrett's esophagus
mild or neglected
symptoms
the cancer
will be
diagnosed
at its late stage
-Tumors of pylorus may
cause gastric outlet obstruction
because it’s where the
food exits
-May be asymptomatic