A 57yo man with blood group A complains of symptoms of vomiting, tiredness, weight loss and
palpitations. Exam: hepatomegaly, ascites, palpable left supraclavicular mass. What is the most
likely dx?
a. Gastric carcinoma
b. Colorectal carcinoma
c. Peptic ulcer disease
d. Atrophic gastritic
e. Krukenburg tumor
answer: A
Risk Factors of Stomach cancer
• H. pylori, causing chronic atrophic gastritis
• hereditary nonpolyposis colorectal cancer (HNPCC), hereditary diffuse gastric carcinoma (HDGC)
• smoking, alcohol, smoked food, nitrosamines
• pernicious anemia associated with achlorhydria and chronic atrophic gastritis
• gastric adenomatous polyps
• previous partial gastrectomy (>10 yr post-gastrectomy)
• hypertrophic gastropathy
• blood type A
Signs of Metastatic Gastric Carcinoma
Virchow’s Node: left supraclavicular node
Blumer’s Shelf: mass in pouch of Douglas
Krukenberg Tumor: metastases to ovary
Sister Mary Joseph Node: umbilical metastases
Irish’s Node: left axillary nodes