Surgery MCQ 95

Most common site of metastasis of gastric carcinoma is:

A. Liver

B. Lung

C. Bone

D. Brain

Answer: A (G+S)

The Correct Answer is  Liver (REF)

Metastasis of gastric carcinoma

• Hematogenous spread
• Liver (most common)
• Lung
• Skeleton
• Brain
• Lymphangitic spread
• Virchow node: left supraclavicular lymph node metastasis 
• Sister Mary Joseph node: periumbilical lymph node metastasis (subcutaneous) 
• Krukenberg tumor: metastatic tumor of the ovary cause by diffuse gastric cancer
• Celiac, paraaortic, and mesenteric lymph nodes
• Lymph nodes of the lesser and greater curvature
• Mediastinal lymph nodes (in carcinoma of the cardia)
• Local invasion of adjacent structures
• Peritoneal carcinomatosis (seeding of  abdominal tumor to the peritoneum)
• Infiltration of structures such as the esophagus, pancreas and transverse colon.
• Direct seeding: Blumer shelf (direct seeding to the pouch of Douglas)

Blumer's shelf is a finding felt in rectal examination that indicates that a tumor has metastasized to the pouch of Douglas.

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