Gastric cancer (summary)

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.

Reference article

This is a summary article; read more in our article on gastric cancer.

Summary

• epidemiology
  • uncommon before the age of 40 years
  • incidence rises rapidly to the age of 70 years (median age)
• presentation
  • 50% have no symptoms
  • non-specific symptoms in the early stages, e.g. dyspepsia
  • anorexia and weight loss
• pathophysiology
  • adenocarcinoma is the commonest stomach cancer (95%)
  • associations with H. pylori
  • 10% genetic component
• investigation
  • endoscopy used to visualize and biopsy
  • CT used for staging of metastatic disease
• treatment
  • 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.

Radiographic features

CT

• 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)

Fluoroscopy

Not used very much in standard practice, but can depict an irregular gastric surface and ulceration.