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Surgery MCQ 95

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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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