This 60 year old woman presented with ascites. Aspiration revealed blood stained fluid. Cytology was positive for malignant cells.
The stomach has been mounted with a portion of spleen and opened to display the mucosal surface. On the greater curvature adjacent to the spleen is a large fungating tumour 12 cm in greatest diameter, which projects into the lumen. Histologically this was a well differentiated adenocarcinoma of the stomach.
Transcoelomic spread is well recognised with gastric cancer.