GASTRIC CARCINOMA Flashcards
What is the most common gastric carcinoma?
What are the two main types? Describe
95% adenocarcinoma
Intestinal: end-result of inflammatory process that progresses from chronic to atrophic gastritis, intestinal metaplasia and dysplasia
Diffuse: idiopathic, stomach becomes diffusly thickened like leather (linitis plastica)
What type of gastric carcinoma is this?
Intestinal type adenocarcinoma
Large ulcer with irregular margins → very concerning
What is the classic demographic for intestinal gastric cancer?
What is the classic risk factor?
Old men
Smoking
What substance in bacon, ham and smoked meats can increase risk of gastric cancer?
Nitrosamines
What blood type is at increased risk of intestinal gastric cancer? Explain why
Type A
→ increased risk of autoimmune gastritis and carcinoma: mechanism unclear
Which type of gastric cancer is associated with signet ring cells?
Diffuse
Most common site of metastases of gastric cancer
Liver
What is this clinical sign? Where is it normally seen? What does it usually indicate? What can it rarely indicate?
Acanthosis nigricans
- Classically seen in folded skin e.g. neck, axilla
- Associated with insulin resistance, obesity
- Rarely associated with malignancy: gastric adenocarcinoma
Patient presents with the following dermatological signs. Sudden in onset. What is the sign and what is it indicative of? What should you do?
Leser–Trélat sign → explosive onset of multiple seborrheic keratoses (many pigmented skin lesions)
Can be sign of internal malignancy, part of paraneoplastic syndrome → gastric adenocarcinoma most common
♦ URGENT ONCOLOGY REFERRAL NEEDED
Patient presents with the following. What is it and what does it indicate?
Virchow’s node: left supraclavicular lymph-node (drains stomach)
Patient presents with painful periumbilical mass, pictured. What is this sign, what does it indicate?
Sister Mary Joseph nodule
Palpable nodule bulging into umbilicus as a result of metastasis in pelvis or abdomen. Can be painful on palpation
