Gastric Carcinoma

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Krukenberg Tumour

Aetiology

• Haemophilus Influenzae
• hypochloria
• blood group A
• reduced fresh fruit and vegetables in diet

Symptoms

• imitates Peptic Ulcer Disease
• Dysphagia
• vomiting

Examination

• epigastric tenderness
• palpable mass
• hard
• irregular
• cannot get above it
• moves with respiration
• Virchow's node / Troisier's sign 

Investigations

• OGD
  • tumour
  • malignant ulcer
  • stricturing

Pathology

Macroscopic

• polypoid (fungating)
• ulcerating (uneven base, irregular margin)
• diffuse

Microscopic

• intestinal type
  • glandular formation
  • lined by mucus secreting cells
  • expansile growth, well demarcated
• diffuse
  • chains of single cells
  • poorly demarcated
  • "signet ring" cells

Spread

• peritoneal dissemination
• lymphatic
  • right and left gastric arteries→coeliac nodes
  • left supraclavicular (Virchow's node)
• haematogenous
  • liver

Types

• leather bottle stomach

Treatment

• gastrectomy

Prognosis

• poor

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