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Gastric Carcinoma 4 (Clinical Features (Advanced carcinoma: (-Tumors of…

- - - - 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
    - - the cancer
        will be
        diagnosed
        at its late stage
- - - - The most common
        and the earliest
        LN Mets may involve
        the
        
        supraclavicular lymph
        node (Virchow’s node)
    - - can also go to
        distant organs and most commonly it prefers to go to the
        
        liver via vascular
        dissemination
        (mainly to liver)
    - - through the
        wall into the
        serosa
    - - 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)