The time-honored group of symptoms for gastric carcinoma, which have long since become classic, are more often absent now that exploratory operations are common. When we do have the classical symptoms of cancer the case is usually beyond surgical relief. It is, therefore, the atypical case which should engage our attention, because in this group of stomach troubles we shall find those which may be relieved by early operation.
Frequently we find on opening the abdomen that surgery has been employed too late to benefit the patient. And in so many of these hopeless malignant cases there is found distinct evidence of an old ulcer on the base of which malignancy has been grafted, the constant irritation of hyperacidity with its attending pain and distress having converted a benign growth into one of malignancy.
As a rule the ulcer-bearing area is at the pylorus. When malignancy occurs here it is
TENNANT CE. SOME ATYPICAL SYMPTOMS IN GASTRIC CARCINOMA, WITH REPORT OF A CASE.. JAMA. 1908;LI(20):1695–1696. doi:10.1001/jama.1908.25410200043002a
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