ADENOCARCINOMA OF THE STOMACH
This 82 year old woman was admitted to the Alfred Hospital following a massive melaena. She was severely shocked and died minutes after arrival.
This specimen includes oesophagus, stomach, proximal duodenum and pancreas. The stomach has been opened out to display a large gastric ulcer measuring 7 x 5 cm on the lesser curve. The ulcer is shallow and broad with a raised rolled edge. There are no radiating mucosal folds. The floor of the ulcer is covered with necrotic debris. Cut sections through the ulcer reveal elevation of the edge by pale homogenous tumour tissue, and the presence of a large artery in the ulcer base. The pancreas is adherent to the serosal aspect of the ulcer. Histologically this proved to be an ulcerating, well differentiated adenocarcinoma of the stomach with direct spread into the pancreas. (At post mortem, 2 eroded arteries with evidence of recent haemorrhage, were found within the ulcer crater).