(Cancer)

Overview

• 5th most common cancer worldwide, High incidence in Asia.
• M>F, Usual age of presentation >50 yrs
• Risk Factors → diets rich in nitrates/salts (dried foods, smoked foods), H.pylori infection, smoking, pernicious anaemia
  • Pernicious Anaemia ⇒ antibodies against gastric parietal cells, leading to reduced IF and B12 deficiency (macrocytic anaemia).
• Adenocarcinoma is most common form (95% of cases), most commonly located on lesser curvature

Making Diagnosis

Clinical Features:

• Abdominal Pain → typically vague, epigastric pain. May present as dyspepsia.
• Weight loss
• Lymphadenopathy (Virchow’s Node) → swelling in left supraclavicular area is a sign of lymphatic spread gastric malignancy
  • Sister Mary Joseph’s Nodule ⇒ metastatic node on the umbilicus
• Acanthosis Nigracans → symmetrical, brown, velvety plaques found on neck, axilla or groin
• Krukenberg tumour → ovarian mass as a result of metastasis from a gastric tumour can be a rare presentation in women

Presence of risk factors is key diagnostic feature

Investigations: