clinical features

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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

Last reviewed 11/2020

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