Adenocarcinoma of the lesser curvature with signet-ring cells.
This 34 year old female, lawyer who 4 months previously delivered her second baby and has another baby of three years, due to an abdominal pain an upper endoscopy was performed, weight loss of 10 pounds was reported.
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All endoscopic images shown in this Atlas contain video clips.We recommend seeing the video clips in full screen mode.
Video Endoscopic Sequence 2 of 8.
Chromoendoscopy using Lugol's solution.
At thegastric angle an irregular folders are found.
The image and video display some typical parameters of criteria of a malign ulcer.
1. Fold tapering 2. Ulcer 3. Fusion of folds 4. Abrupt termination of fold 5. Bulbous enlargement.
Video Endoscopic Sequence 3 of 8.
In this image and video clip is observed an irregular ulceration found it at the lesser curvature and the anterior wall of the stomach which fulfill of criteria of a malign infiltration.
Video Endoscopic Sequence 4 of 8.
Another image of the folds that converges in abnormal form.
Video Endoscopic Sequence 5 of 8.
Retroflexed Image.
Video Endoscopic Sequence 6 of 8.
Magnifying Endoscopy 150x.
Some ulcerated areas with neovascularization are observed.
Video Endoscopic Sequence 7 of 8.
Chromoendoscopy using indigo carmin.
Video Endoscopic Sequence 8 of 8.
Magnifying Endoscopy 150x.
Some ulcerated areas with neovascularization, ulcerated areas, and cellular agglomerate are seen.
Video Endoscopic Sequence 1 of 3.
Adenocarcinoma of the lesser curvature with signet-ring cells.
This 56 year-old man, who two months previously initiates sintomatology with loss weight, satiety and postprandial vomiting.
Video Endoscopic Sequence 2 of 3.
In this image and video clip is seen an irregular ulceration of the body and antrum.
Video Endoscopic Sequence 3 of 3.
In this image as well as the video clip you can seen another view of the neoplasia.
Video Endoscopic Sequence 1 of 3.
In this endoscopic sequence a reflux esophagitis is observed due to an obstructed gastric cancer of the antrum.
Video Endoscopic Sequence 2 of 3.
An ulcerated obstructed neoplasia is seen at the gastric antrum.
This 56 year- old male, who presented with early satiety and postprandial vomiting, suggestive of gastric outlet obstruction, along with weight loss and anemia. Endoscopy demonstrated an ulcerated mass.
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Video Endoscopic Sequence 3 of 3.
Biopsy revealed the lesion to be adenocarcinoma
Video Endoscopic Sequence 1 of 2.
krukenberg´s Tumor.
A 56 year-old female, gynecologist doctor, underwent a laparotomy due to ovarian tumor, at surgery, a gastric adenocarcinoma was detected.
F. E. Krukenberg:er das Fibrosarcoma ovarii mucocellulare (carcinomatodes). Archiv für Gynäkologie, Berlin, 1896, 50: 287-321. Medline.
Video Endoscopic Sequence 2 of 2.
The carcinoma proved to be inoperable. The image and video clip shows the post surgical status. Only a anastomosis was performed. Both ovaries have been infiltrated.
In 1896 Krukenberg described what he presumed was a new type of primary ovarian neoplasm. The true metastatic nature of this lesion was established six years later. Some 5 – 10% of all ovarian malignant lesions are regarded as metastatic. Of them approximately 50% are Krukenberg tumours, which have well defined histologic characteristics (carcinoma with signet-ring cells and stroma with sarcomatoid reaction). Krukenberg tumor is secondary to a neoplastic process in the gastrointestinal tract. The stomach is the commonest primary site (2% of all women with gastric cancer develop ovarian metastasis), followed by the colon. Gallbladder, biliary ducts and appendix can also be the source of the primary neoplasm.
Video Endoscopic Sequence 1 of 2.
A 52 year-old female with epigastric pain and vomiting. No weight loss was reported. The morphological appearance was that of a big ulcer with suspected malignancy. However, multiple biopsies of the first endoscopy did not reveal any malignant cells. Our recommendation was a repeat the endoscopy in six week. Ulcerated Gastric Carcinoma at the gastric angle was found.
Video Endoscopic Sequence 2 of 2.
Same case as above. The patient did not improve her symptoms. We had recommended a new endoscopy after the treatment. The malignant appearance became even more obvious after two months. Biopsies of gastric ulcer must be taken at least twice, even when only an ulcer scar is visible at the second examination. This is because often the presence of abundant necrosis causes false negative biopsies.
A 79 year-old female who complained of severe epigastric pain and weight loss of 20 pounds. The video endoscopic procedure revealed an ulcerated carcinoma of the gastric body. All cases shown in this atlas are patients that I have personally seen in my private practice, where I have observed a very high incidence of gastric cancer. Patients of a low socioeconomic status, that are seen at public or charity hospitals, have an even higher incidence of this disease.
Video Endoscopic Sequence 2 of 2.
Bleeding is observed, the ulcerated adenocarcinoma at the greater curvature.
Ulcerated Gastric Adenocarcinoma of the gastric incisure.
A 60 year-old female with weight loss and vomiting. Ulcerated Gastric Adenocarcinoma of the gastric incisure with signet ring cell.
Ulcerated Gastric Carcinoma.
A 66 year-old male with abdominal pain, nausea, Vomiting and weight loss. An ulcerated gastric carcinoma at the corpus was found.
Video Endoscopic Sequence 1 of 2.
A 57 year-old female who had history of a previous upper gastrointestinal endoscopies over several years, performed elsewhere. On her visit to our clinic, she complained of epigastric pain and disuria. A severe urinary tract infection was detected and ciprofloxacine was prescribed. The next morning an upper gastrointestinal endoscopy was performed, a tablet of ciprofloxacine taken at 3 am, was found at the cardias ( endoscopy was performed at 9.11 am) The tablet still seen in the esophagus, which is not considered normal, since food and medicines travel immediately to the stomach after being ingested. Therefore, the suspicion of a disease in this region arises
VideoEndoscopic Sequence 2 of 2.
Ulcerated Gastric Carcinoma of the fundus retroflexed view.
Video Endoscopic Sequence 1 of 17.
Adenocarcinoma of the cardias and gastric fundus with signet-ring cells.
A 34 year-old male, who presented dysphagia for solids and liquids.
Video Endoscopic Sequence 2 of 17.
In the retroflexed image a large ulcerated tumor is observed at the gastric fundus.
Video Endoscopic Sequence 3 of 17.
The gastric cardias is observed with extensive infiltration.
Video Endoscopic Sequence 4 of 17.
More images and video clips.
Video Endoscopic Sequence 5 of 17.
There is an ulcer at the gastroesophageal junction. The antral mucosa is edematous.
Video Endoscopic Sequence 6 of 17.
This view shows the irregular border of the ulcer at the esophagogastric junction.
Video Endoscopic Sequence 7 of 17.
It is shown the fundus of the neoplasia with irregular and granular surface.
Video Endoscopic Sequence 8 of 17.
This view shows the irregular border of the ulcer at the esophagogastric junction.
Video Endoscopic Sequence 9 of 17.
It is shown the fundus of the neoplasia with irregular and granular surface.
Video Endoscopic Sequence 10 of 17.
There is a slight malignant epithelial infiltrates into the lamina propria.
Video Endoscopic Sequence 11 of 17.
It is clearly visible the malignant epithelial cells at the muscular propria.
Video Endoscopic Sequence 12 of 17.
There are mucosecreting malignant glands.
Video Endoscopic Sequence 13 of 17.
There are malignant epithelial cells, some of them wit clear cytoplasm.
Video Endoscopic Sequence 14 of 17.
Picture of a metastatic glandular neoplasia to lymph nodes.
Video Endoscopic Sequence 15 of 17.
The ring shape of the epithelial malignant cells is the predominant histologic pattern.
Video Endoscopic Sequence 16 of 17.
Picture of a metastatic glandular neoplasia to lymph nodes.
Video Endoscopic Sequence 17 of 17.
One year after the surgery a follow up endoscopy was performed finding this malign nodule at the distal esophagus.
