carcinoma at early tumor stage typically produces mild or no
symptoms. This explains why at the time of disease detection
in the West the tumor is often locally advanced or metastatic.
As the tumor becomes more extensive, an insidious upper abdominal
discomfort may develop, ranging in intensity from a vague sense
of postprandial fullness to a severe, steady pain. Anorexia,
nausea, vomiting and weight loss are also frequently reported
at the time of presentation, whereas dysphagia may be the main
symptom associated with a lesion of the cardia. Hematemesis
or melena is reported by 20 percent of patients but it is more
likely to be associated with leiomyoma and leiomyosarcoma. There
are no physical findings associated with early gastric cancer,
and the presence of a palpable abdominal mass generally indicates
long-standing growth and regional extension. Laboratory tests
may demonstrate anemia, hypoproteinemia, abnormal liver function,
and fecal occult blood.
Patients with gastric carcinoma infrequently present with various
paraneoplastic conditions such as microangiopathic hemolytic
anemia, membranous nephropathy, the sudden appearance of seborrhcic
Keratoses (the Leser-Trelat sign), filiform and papular pigmented
lesions in skin folds and mucous membranes (acanthosis nigricans),chronic
intravascular coagulation leading to arterial and venous thrombi
(Trousseau's syndrome) , and in rare cases, dermatomyositis.