AA.Gastric C II 06. ppt

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