Supra-clavicular lump (392/1700)

A 57yo man with blood group A complains of symptoms of vomiting, tiredness, weight loss and
palpitations. Exam: hepatomegaly, ascites, palpable left supraclavicular mass. What is the most
likely dx?
a. Gastric carcinoma
b. Colorectal carcinoma
c. Peptic ulcer disease
d. Atrophic gastritic
e. Krukenburg tumor
































answer: A

Risk Factors of Stomach cancer
• H. pylori, causing chronic atrophic gastritis
hereditary nonpolyposis colorectal cancer (HNPCC), hereditary diffuse gastric carcinoma (HDGC)
• smoking, alcohol, smoked food, nitrosamines
pernicious anemia associated with achlorhydria and chronic atrophic gastritis
• gastric adenomatous polyps
• previous partial gastrectomy (>10 yr post-gastrectomy)
• hypertrophic gastropathy
blood type A

Signs of Metastatic Gastric Carcinoma
Virchow’s Node: left supraclavicular node

Blumer’s Shelf: mass in pouch of Douglas

Krukenberg Tumor: metastases to ovary

Sister Mary Joseph Node: umbilical metastases

Irish’s Node: left axillary nodes

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