19945              CARCINOMA OF THE STOMACH

The patient was a man aged 80. A carcinoma of the stomach had been discovered 12 months previously but he declined treatment. There were very few symptoms except weight loss until 7 months later, when a painless lump appeared in the epigastrium and he began to vomit. He died quietly 5 months later. At postmortem there were metastases in the liver and adrenals and in the abdominal wall above the umbilicus.

The specimen consists of the stomach opened to show a fungating carcinoma high up on the lesser curvature.  Irregular friable necrotic tumour tissue is present on the surface and the tumour has produced an organic hour-glass constriction through which one finger passed with difficulty.  The reverse of the specimen shows direct extension of the tumour into the lesser omentum and a large malignant mass beneath the stomach in the greater omentum.  Histology shows well differentiated columnar-cell adenocarcinoma.