23807              CARCINOMA OF THE STOMACH

The patient was a man aged 44 with a 7-year history of epigastric pain unrelated to meals.  Gastroscopy showed extensive malignant infiltration of the stomach, which on biopsy proved to be an anaplastic carcinoma.  Surgery was considered impossible and he died in hospital of malignant cachexia 7 weeks later.

The specimen consists of the stomach and the duodenum viewed from behind.  There is an infiltrating carcinoma of the pyloric region 10 cms in length.  The bulk of the tumour is on the lesser curvature, extending anteriorly around the wall of the pylorus where much subserous infiltration can be seen on the reverse of the specimen.  The inner surface of the tumour is nodular and the pyloric canal is greatly narrowed to a diameter of only a few mms.  There is marked hypertrophy of the muscle coat underlying the pyloric tumour, and there is some organic hour-glass contraction at the upper border of the tumour.  The duodenum is dilated but appears normal.  Histology shows a mucin-secreting carcinoma with many signet ring cells.