MINI-REVIEW

Roukos DH, and Agnantis NJ
From the Departments of Surgery (DHR) and Pathology (NJA), Ioannina University School of Medicine, 45110 Ioannina, Greece,
droukos@cc.uoi.gr

Gastric carcinoma at early tumor stage typically produces mild or no symptoms. This explains why at the time of disease detection in the West the tumor is often locally advanced or metastatic. As the tumor becomes more extensive, an insidious upper abdominal discomfort may develop, ranging in intensity from a vague sense of postprandial fullness to a severe, steady pain. Anorexia, nausea, vomiting and weight loss are also frequently reported at the time of presentation, whereas dysphagia may be the main symptom associated with a lesion of the cardia. Hematemesis or melena is reported by 20 percent of patients but it is more likely to be associated with leiomyoma and leiomyosarcoma. There are no physical findings associated with early gastric cancer, and the presence of a palpable abdominal mass generally indicates long-standing growth and regional extension. Laboratory tests may demonstrate anemia, hypoproteinemia, abnormal liver function, and fecal occult blood.
Patients with gastric carcinoma infrequently present with various paraneoplastic conditions such as microangiopathic hemolytic anemia, membranous nephropathy, the sudden appearance of seborrhcic Keratoses (the Leser-Trelat sign), filiform and papular pigmented lesions in skin folds and mucous membranes (acanthosis nigricans),chronic intravascular coagulation leading to arterial and venous thrombi (Trousseau's syndrome) , and in rare cases, dermatomyositis.