Ulcerated Gastric Adenocarcinoma withSignet Ring Cells.
This 47 year-old male, presented with weight loss of 50 pounds with no prior gastrointestinal symptoms, has a ulcerated gastric adenocarcinoma, immediately after the gastroesophagic junction.
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Video Endoscopic Sequence 2 of 6.
Extending from the GE junction along the lesser curve and posteriorly was a poorly defined non-ulcerative irregular mucosa. This measured approximately 2 x 3cm.
Video Endoscopic Sequence 3 of 6.
Gastric cancer remains a difficult disease to cure in Western countries, primarily because most patients present with advanced disease. Even patients who present in the most favorable condition and who undergo curative surgical resection often die of recurrent disease.
Video Endoscopic Sequence 4 of 6.
The narrow band imaging (NBI) system consists of a sequential electronic endoscope system and a source of light equipped with new narrow band filters, yielding very clear images of microvessels on mucosal surfaces.
Video Endoscopic Sequence 5 of 6.
A newly developed narrow-band imaging (NBI) system, which uses modified optical filters, can yield clear images of microvessels and surface structure in gastric and colonic diseases.
Video Endoscopic Sequence 6 of 6.
NBI displays enhanced images of capillaries in the mucosal surface and detailed mucosal texture by irradiating two narrow wave bands (390–445 nm/530–550 nm) which are strongly absorbed by circulating hemoglobin. If signal processing is performed using a pseudo-narrow band image, the state of mucosa tissues and observation conditions influence the results and good effects cannot be obtained. However, with NBI, the wavelength of the irradiating light itself is altered, and capillaries in the mucosal surface and detailed mucosal texture can thus be processed effectively and stably.
Video Endoscopic Sequence 1 of 6.
Ulcerated Gastric Adenocarcinoma at the distal body.
This 67 year-old female presented with anorexia and lost of weight of 10 pounds.
The images as well as the video clips display a small size neoplasia at the greater curvature in the distal body and posterior wall limiting with the antrum.
Video Endoscopic Sequence 2 of 6.
Most patients are elderly at diagnosis. The median age at diagnosis is 65 years (range 40-70 y). The gastric cancers that occur in younger patients may represent a more aggressive variant.
Video Endoscopic Sequence 3 of 6.
More images and video clips.
Video Endoscopic Sequence 4 of 6.
Chromoscopy with indigo carmine.
The image shown here, is in the limit with the neoplasia, biopsies reveled intestinal metaplasia.
Video Endoscopic Sequence 5 of 6.
Chromoscopy with lugol´s.
Video Endoscopic Sequence 6 of 6.
Retroflexed Image.
Video Endoscopic Sequence 1 of 5.
Extensive Gastric Adenocarcinoma.
This 56 year old lady, two months previously initiate with abdominal pain, nausea, early satiety and postprandial vomiting and weight loss. Endoscopy demonstrated this large lesion.
Video Endoscopic Sequence 2 of 5.
Endoscopy revealed adenocarcinoma, seen here from the antrum. The tumor extended into the lesser curvature near of the gastric fundus.
Video Endoscopic Sequence 3 of 5.
Although the incidence of stomach cancer has declined dramatically in the United States and Western Europe in the last 50 years, the disease remains a serious problem in much of the rest of the world, where it's a leading cause of cancer death.
Video Endoscopic Sequence 4 of 5.
This global variation is almost certainly linked to two factors that play a major role in the development of stomach cancer: Infection with Helicobacter pylori (H. pylori) bacteria and the type of diet.
Video Endoscopic Sequence 5 of 5.
Stomach cancer is more readily treated when caught early. Unfortunately, by the time it causes symptoms, the disease is often at an advanced stage and may have spread beyond the stomach. Yet there is encouraging news. You can reduce your risk of this serious cancer by making a few changes in your lifestyle.
Video Endoscopic Sequence 1 of 3.
Gastric Adenocarcinoma of the LesserCurvature.
This 83 year-old female, with no prior gastrointestinal symptoms,presented withone week of epigastric pain and one month of weight loss of more than 20 pounds.
Worldwide, gastric carcinoma is the most common cancer after lung cancer and a major cause of mortality and morbidity.
Video Endoscopic Sequence 2 of 3.
Gastric Adenocarcinoma of the LesserCurvature.
Enormous malign ulceration is seen.
Advanced lesions have already invaded the muscularis propria. They are associated with metastases to regional lymph nodes or to local or distant structures.
Early gastric lesions are confined to the mucosa or submucosa. Most reports are from Japan, as a result of mass screening there. Patients with these tumors have a 5-year survival rate of 90%.
Video Endoscopic Sequence 3 of 3.
Gastric Adenocarcinoma.
Pathophysiology: The accepted pathway involves transitions from gastritis to gastric atrophy to metaplasia to dysplasia and, finally, to cancer.
Several dietary and environmental factors may influence this pathway.
Hypochlorhydria: This condition occurs in gastric atrophy and promotes bacterial colonization of the stomach. It leads to increased nitrite formation, which may have a mutagenic effect on the atrophic gastric mucosa.
Helicobacter pylori: Antral gastritis caused by H pylori has been linked to the development of gastric cancer. Patients with H pylori gastritis are 3-6 times more likely to develop gastric cancer than individuals without the infection.
Certain foods: Starch, pickled vegetables, salted fish and meat, smoked foods, and salt have all been implicated.
Cigarette smoking: Those who smoke more than 30 cigarettes per day have a 5-fold increased risk of gastric carcinoma.
Video Endoscopic Sequence 1 of 3.
Gastric Adenocarcinoma with extensive duodenal infiltration.
This 69 year old male, presented with weight loss more than 20 pounds and severe abdominal pain with nocturnal predominance.
Video Endoscopic Sequence 2 of 3.
This image displays the pylorus and the duodenal bulb that be infiltrated by the tumor.
Video Endoscopic Sequence 3 of 3.
Extensive infiltration into the duodenal bulb.
Biopsies proven to be a gastric adenocarcinoma of the antrum with duodenal infiltration.
Obstructed adenocarcinoma of the Gastric Antrum.
A44 year-old man, who complained of weight loss and persisting vomiting. An upper endoscopy was performed, a doughnut-shaped gastric cancer of the antrum was found.
Extensive collection of gastric carcinoma is on display on this web site, this reflects the high incidence of stomach cancer in the republic of El Salvador. Gastric Cancer is the second most frequent cancer in this country, second only to carcinoma of the cervix. Many cases shown here are in a very advanced stage, since a large part of the population does not visit a physician until clinical symptoms are very advanced.
Endoscopic Sequence 1 of 4.
Gastric Adenocarcinoma of the Gastric Cardias.
A 74 year-old female with abdominal pain and nauseas. The an upper gastroscopy displays a nodular and ulcerated small mass at the gastric cardias.
Esophageal cancer and cancer of the gastric cardia, in particular adenocarcinomas, have shown a rapid and largely unexplained increase in incidence in many developed countries around the world. These diseases have a poor prognosis and current therapies have a modest impact on survival. Tytgat GN, Bartelink H, Bernards R, Giaccone G, van Lanschot JJ, Offerhaus GJ, Peters GJ. Cancer of the esophagus and gastric cardia: recent advances. [Medline].
Video Endoscopic Sequence 2 of 4.
Another image and video of that small neoplasia, however The cat scan displays that the liver is infiltrated with metastases.
CT is primarily used to preoperatively assess patients with gastric carcinoma. CT is to assess the presence and extent of extragastric spread. This information is vital in deciding between palliative surgery and curative radical surgery. Therefore, the main role of CT is to identify patients who would not benefit from radical surgery. Thus, CT is used to stage the tumor and also to monitor the response to treatment.
VideoEndoscopic Sequence 3 of 4.
This image and the video was taken with magnifying endoscope. Irregular texture is observed. Some areas are ulcerated.
VideoEndoscopic Sequence 4 of 4.
This magnifying image displays a tiny irregular ulcer.
Ulcerated Submucosal Adenocarcinoma that produced extensive carcinomatosis.
Endoscopic Sequence 1 of 2.
This 84 year-old male, presented with dysphagia and weight lost.
