AA.Gastric C II 06. ppt
AA.Gastric C II 06. ppt
AA.Gastric C II 06. ppt
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GASTRIC ADENOCARCINOMA<br />
Dissemination. I.<br />
* by direct extension through gastric wall to perigastric<br />
tissues (occasionally adhering to adjacent organs such<br />
as pancreas, colon or liver);<br />
- via lymphatics to intraabdominal (frequent) and<br />
supraclavicular lymph nodes (Troisier’ sign);<br />
- by seeding of peritoneal surfaces [metastatic<br />
nodules to ovary (Krukenberg's tumor), periumbilical<br />
region ("Sister Mary Joseph node") or peritoneal cul-desac<br />
(Blumer's shelf)];<br />
- malignant ascites;<br />
- hematogenous spread (more frequently to liver)