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