Malignant Gastric and Duodenal Tumors Adenocarcinoma

Gastric carcinoma is decreasing in frequency in Western counties and duodenal carcinoma is rare. By the time they become markedly symptomatic, the tumors are often advanced and beyond cure. The role of the radiologist at that point is to locate and stage the tumor. However, radiographic studies performed for other reasons provide the potential for detection of asymptomatic early gastric carcinoma.

Sometimes epithelial malignancies grow into the lumen as a mainly cellular mass of tissue with little fibrosis. Such a lesion is more often well-differentiated. Typically, the surface is lobulated or ulcerated, as opposed to the usually smooth surface of benign lesions (Fig. 8).

Mucin-producing tumors have a tendency to infiltrate widely and incite a great deal fibrotic reaction. Fold thickening may result, and often the wall is thickened and appears stiff and constricted, producing the classic 'leather bottle' appearance. The lesion may extend around the lumen in an annular manner (Fig. 9) [4, 5].

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