Clinical features
Initial presentation is insidious. Patients are most commonly over 50 years of age and develop dyspepsia that may be mistaken for a symptom of an ulcer.
Later features of gastric carcinoma include:
- anorexia and weight loss in more than 95%
- pyloric obstruction
- haematemesis in 5%
- dysphagia with proximal lesions
- epigastric pain - late feature
- palpable mass - 33%
- hepatomegaly
- peritoneal seedlings which may lead to:
- ascites
- ovarian mass (Krukenburgs tumour)
- pelvic mass
- enlarged left supraclavicular node - Virchow's node, Troisier's sign
- may present with perforation
- association with acanthosis nigricans and dermatomyositis
- pleural effusions if the cancer has spread to the lungs
- Sister Joseph nodule
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