Learning objectives
- Review the most characteristic imaging features of gastric cancer.
-Focus on the differential diagnosis of the most frequent histological subtypes of gastric carcinoma,
which are: adenocarcinoma,
lymphoma,
gastrointestinal stromal tumor (GIST) and carcinoid tumor.
Background
a.
INTRODUCTION
Gastric cancer is the 6th most frequent malignancy in Europeand constitutes the 2nd most common carcinoma involving the gastrointestinal (GI) tract,
after colorectal carcinoma.
It is considered the 4th most common cause of cancer-related death.
Delayed detection is usual,
with the disease being disseminated in more than a half of the patients.
In fact,
approximately 60% of allpresent with unresectable disease.
As a consequence,
gastric cancer has a poor long-term clinical outcome,
with five-year survival rates varying from 10% to 30% in Europe....
Findings and procedure details
Once reviewed the key concepts of gastric cancer,
the next step is to approach its imaging features.
Gastric cancer consists offour main histopathologic subtypes,
each of them presenting different biological behaviouranddistinct imaging appearance on which radiologists can relyon to reach an accurate diagnosis.
a.
GASTRIC ADENOCARCINOMA
It is the dominant subtype of gastric cancer (accounting for almost 90-95% of all cases).
General concepts
- Gastric ADC presents high incidence in Asia,
South-American Andine region and Eastern Europe.
- It mostly affects to >60-70 y.o.
patients...
Conclusion
Imaging diagnosis of gastric cancer is challenging due to its wide spectrum of radiological findings.
However,
recognizing the most determinant characteristics of its main subtypes makes this task easier and enables an accurate and prompt diagnosis of the disease,
leading to better survival rates.
Therefore,
it is wortwhile to take a look at the stomach.
References
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Gastric cancer staging at multi-detector row CT gastrography: comparison of transverse and volumetric CT scanning.
Radiology 2006;236(3):879-885.
Sitarz R,
Skierucha M,
Mielko J,
et al.
Gastric cancer: epidemiology,
prevention,
classification and treatment.
Cancer Manag Res 2018;10:239-248.
Waddell T,
Verheij M,
Allum W,
et al.
Gastric cancer: ESMO - ESSO - ESTRO clinical practice guidelines for diagnosis,
treatment and follow-up.
EJSO...