STOMACH - Carcinoma ('leather bottle')

The wall of the stomach is diffusely thickened from just below the cardia to close to the pylorus. The mucosal folds are flattened, and the cut surface shows that much of the thickening is apparently in the sub-mucosa, although, at one point, on the lesser curvature, the serosa is involved.
In October 1974, this woman noted the onset of severe constant epigastric pain following a meal. Antacids gave no relief; endoscopy in April showed only inflammatory changes; an X-ray in June 1975 showed a carcinoma in the stomach. During this latter time, the patient noted loss of weight and difficulty in swallowing solid food, together with early satiety. Histologically, this is a diffuse infiltrating carcinoma; sections of lymph nodes examined showed no tumour infiltration. In February 1976, she presented with fluctuating dysphasia and regurgitation of food; there was no evidence at this time of recurrent tumour.