Gastric Adenocarcinoma

Left: 46 year-old man with no prior gastrointestinal symptoms, presented with five days of epigastric pain. Initial studies revealed iron-deficiency anemia and blood in the stool. Endoscopy demonstrated this lesion on the lesser curvature which appeared to be edematous folds with a central ulceration, but which on biopsy proved to be a poorly differentiated adenocarcinoma, signet ring cell type.
Center: 50 year-old man who had undergone seemingly successful resection of adenocarcinoma involving the gastric antrum, now undergoing endoscopy for routine postoperative screening several months later. Endoscopy revealed a poorly distensible, ulcerated distal gastric remnant. Biopsies confirmed the suspicion of recurrent carcinoma.
Right: 87 year-old woman was found to be anemic and to have occult blood in the stool; she had no gastrointestinal symptoms of any kind. Endoscopy revealed this ulcerated, sessile, polypoid mass which proved to be adenocarcinoma on biopsy.

Left: 82 year-old woman who presented with early satiety and postprandial vomiting, suggestive of gastric outlet obstruction, along with weight loss and anemia. Endoscopy demonstrated an ulcerated mass with prominent folds, which did not obstruct the gastric outlet. The lesion was an adenocarcinoma of the signet ring cell type.
Center: 54 year-old woman with abdominal pain. Biopsies of this ulcer, with raised margins, revealed poorly differentiated adenocarcinoma, signet-ring type.
Right: 70 year-old man with melena as his only presenting symptom; no nausea, vomiting, early satiety or pain. Endoscopy revealed a partially obstructing adenocarcinoma, seen here from the antrum. The tumor extended into the second portion of the duodenum.