Gastric cancer (summary)
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This is a basic article for medical students and other non-radiologists
Gastric cancer, also known as stomach cancer or gastric carcinoma, refers to a cancer that arises from the mucosal lining of the stomach. It is the commonest gastric malignancy.
- uncommon before the age of 40 years
- incidence rises rapidly to the age of 70 years (median age)
- 50% have no symptoms
- non-specific symptoms in the early stages, e.g. dyspepsia
- anorexia and weight loss
- adenocarcinoma is the commonest stomach cancer (95%)
- associations with H. pylori
- 10% genetic component
- endoscopy used to visualize and biopsy
- CT used for staging of metastatic disease
- partial or total gastrectomy
- +/- chemoradiotherapy
Role of imaging
Imaging is limited to the assessment of distant metastatic disease in stomach cancer. Plain radiograph and ultrasound are of limited value.
- is there distant spread?
CT is the modality that is used for assessment of distant spread. PET-CT is used in some centers.
- performed with negative contrast (distended with water or gas)
- polypoid mass in the stomach
- focal wall thickening
- ulceration (gas-filled ulcer crater in the mass)
Not used very much in standard practice, but can depict an irregular gastric surface and ulceration.