Abstract
Despite advances in molecular biology, imaging, and treatment, gastric neoplasms remain a significant cause of morbidity and mortality; gastric adenocarcinoma is the fifth most common malignancy and third most common cause of death worldwide (Brenner et al., Methods Mol Biol 472:467–477, 2009; Howson et al. Epidemiol Rev 8:1–27, 1986; Roder, Gastric Cancer 5(Suppl 1):5–11, 2002; Ferlay et al., GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. International Agency for Research on Cancer, 2013). Because of both the frequency at which malignant gastric tumors occur as well as the worldwide impact, gastric neoplasms remain important lesions to identify and characterize on all imaging modalities. Despite the varied histologies and behaviors of these neoplasms, many have similar imaging features. Nonetheless, the treatment, management, and prognosis of gastric neoplasms vary by pathology, so it is essential for the radiologist to make every effort to differentiate between these lesions and raise the less common entities as differential diagnostic considerations when appropriate.
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References
Brenner H, Rothenbacher D, Arndt V (2009) Epidemiology of stomach cancer. Methods Mol Biol 472:467–477. doi:10.1007/978-1-60327-492-0_23
Howson CP, Hiyama T, Wynder EL (1986) The decline in gastric cancer: epidemiology of an unplanned triumph. Epidemiol Rev 8:1–27
Roder DM (2002) The epidemiology of gastric cancer. Gastric Cancer 5(Suppl 1):5–11
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin D, Bray F (2013) GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. International Agency for Research on Cancer. http://globocan.iarc.fr. Accessed on October 28, 2014
Park SH, Han JK, Kim TK, Lee JW, Kim SH, Kim YI, Choi BI, Yeon KM, Han MC (1999) Unusual gastric tumors: radiologic-pathologic correlation. Radiographics 19(6):1435–1446. doi:10.1148/radiographics.19.6.g99no051435
Bosman FT, Carneiro F, Hruban RH, Theise ND (2010) WHO classification of tumours of the digestive system. Classification of tumours of the digestive system, 4th edn. IARC Press, Lyon
Hamilton SR, Aaltonen LA (eds) (2000) World Health Organization classification of tumours. Pathology and genetics of tumours of the digestive system. IARC Press, Lyon
Washington K (2010) 7th edition of the AJCC cancer staging manual: stomach. Ann Surg Oncol 17(12):3077–3079. doi:10.1245/s10434-010-1362-z
Yoon H, Lee DH (2014) New approaches to gastric cancer staging: beyond endoscopic ultrasound, computed tomography and positron emission tomography. World J Gastroenterol 20(38):13783–13790. doi:10.3748/wjg.v20.i38.13783
Bentley-Hibbert S, Schwartz L (2015) Use of Imaging for GI Cancers. J Clin Oncol 33(16):1729–1736. doi:10.1200/JCO.2014.60.2847
Park do Y, Lauwers GY (2008) Gastric polyps: classification and management. Arch Pathol Lab Med 132(4):633–640. doi:10.1043/1543-2165(2008)132[633:GPCAM]2.0.CO;2
Feczko PJ, Halpert RD, Ackerman LV (1985) Gastric polyps: radiological evaluation and clinical significance. Radiology 155(3):581–584. doi:10.1148/radiology.155.3.4001357
Carmack SW, Genta RM, Schuler CM, Saboorian MH (2009) The current spectrum of gastric polyps: a 1-year national study of over 120,000 patients. Am J Gastroenterol 104(6):1524–1532. doi:10.1038/ajg.2009.139
Ba-Ssalamah A, Prokop M, Uffmann M, Pokieser P, Teleky B, Lechner G (2003) Dedicated multidetector CT of the stomach: spectrum of diseases. Radiographics 23(3):625–644. doi:10.1148/rg.233025127
Harned RK, Buck JL, Sobin LH (1995) The hamartomatous polyposis syndromes: clinical and radiologic features. AJR Am J Roentgenol 164(3):565–571. doi:10.2214/ajr.164.3.7863873
Levy AD, Quiles AM, Miettinen M, Sobin LH (2005) Gastrointestinal schwannomas: CT features with clinicopathologic correlation. AJR Am J Roentgenol 184(3):797–802. doi:10.2214/ajr.184.3.01840797
Kang HC, Menias CO, Gaballah AH, Shroff S, Taggart MW, Garg N, Elsayes KM (2013) Beyond the GIST: mesenchymal tumors of the stomach. Radiographics 33(6):1673–1690. doi:10.1148/rg.336135507
Hong HS, Ha HK, Won HJ, et al. (2008) Gastric schwannomas: radiological features with endoscopic and pathological correlation. Clin Radiol 63(5):536–542. doi:10.1016/j.crad.2007.05.026
Hur BY, Kim SH, Choi JY, et al. (2011) Gastroduodenal glomus tumors: differentiation from other subepithelial lesions based on dynamic contrast-enhanced CT findings. AJR Am J Roentgenol 197(6):1351–1359. doi:10.2214/AJR.10.6360
Miettinen M, Paal E, Lasota J, Sobin LH (2002) Gastrointestinal glomus tumors: a clinicopathologic, immunohistochemical, and molecular genetic study of 32 cases. Am J Surg Pathol 26(3):301–311
Taylor AJ, Stewart ET, Dodds WJ (1990) Gastrointestinal lipomas: a radiologic and pathologic review. AJR Am J Roentgenol 155(6):1205–1210. doi:10.2214/ajr.155.6.2122666
Lee MH, Choi D, Park MJ, Lee MW (2012) Gastric cancer: imaging and staging with MDCT based on the 7th AJCC guidelines. Abdom Imaging 37(4):531–540. doi:10.1007/s00261-011-9780-3
Levy AD, Abbott RM, Rohrmann CAJr, Frazier AA, Kende A (2001) Gastrointestinal hemangiomas: imaging findings with pathologic correlation in pediatric and adult patients. AJR Am J Roentgenol 177(5):1073–1081. doi:10.2214/ajr.177.5.1771073
Park SH, Han JK, Choi BI, et al. (2000) Heterotopic pancreas of the stomach: CT findings correlated with pathologic findings in six patients. Abdom Imaging 25(2):119–123
Cho JS, Shin KS, Kwon ST, et al. (2000) Heterotopic pancreas in the stomach: CT findings. Radiology 217(1):139–144. doi:10.1148/radiology.217.1.r00oc09139
Kim JY, Lee JM, Kim KW, et al. (2009) Ectopic pancreas: CT findings with emphasis on differentiation from small gastrointestinal stromal tumor and leiomyoma. Radiology 252(1):92–100. doi:10.1148/radiol.2521081441
Fishman EK, Urban BA, Hruban RH (1996) CT of the stomach: spectrum of disease. Radiographics 16(5):1035–1054. doi:10.1148/radiographics.16.5.8888389
Motohara T, Semelka RC (2002) MRI in staging of gastric cancer. Abdom Imaging 27(4):376–383. doi:10.1107/s00261-001-0118-4
Binstock AJ, Johnson CD, Stephens DH, Lloyd RV, Fletcher JG (2001) Carcinoid tumors of the stomach: a clinical and radiographic study. AJR Am J Roentgenol 176(4):947–951. doi:10.2214/ajr.176.4.1760947
Sarlomo-Rikala M, Kovatich AJ, Barusevicius A, Miettinen M (1998) CD117: a sensitive marker for gastrointestinal stromal tumors that is more specific than CD34. Modern Pathol 11(8):728–734
Levy AD, Remotti HE, Thompson WM, Sobin LH, Miettinen M (2003) Gastrointestinal stromal tumors: radiologic features with pathologic correlation. Radiographics 23(2):283–304, 456; quiz 532. doi:10.1148/rg.232025146
Burkill GJ, Badran M, Al-Muderis O, et al. (2003) Malignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread. Radiology 226(2):527–532. doi:10.1148/radiol.2262011880
Agaimy A, Wunsch PH (2009) Lymph node metastasis in gastrointestinal stromal tumours (GIST) occurs preferentially in young patients < or = 40 years: an overview based on our case material and the literature. Langenbeck’s archives of surgery / Deutsche Gesellschaft fur Chirurgie 394(2):375–381. doi:10.1007/s00423-008-0449-5
Miettinen M, Wang ZF, Sarlomo-Rikala M, et al. (2011) Succinate dehydrogenase-deficient GISTs: a clinicopathologic, immunohistochemical, and molecular genetic study of 66 gastric GISTs with predilection to young age. Am J Surg Pathol 35(11):1712–1721. doi:10.1097/PAS.0b013e3182260752
Doyle LA, Hornick JL (2014) Gastrointestinal stromal tumours: from KIT to succinate dehydrogenase. Histopathology 64(1):53–67. doi:10.1111/his.12302
Choi H, Charnsangavej C, de Castro Faria S, et al. (2004) CT evaluation of the response of gastrointestinal stromal tumors after imatinib mesylate treatment: a quantitative analysis correlated with FDG PET findings. AJR Am J Roentgenol 183(6):1619–1628. doi:10.2214/ajr.183.6.01831619
Holdsworth CH, Badawi RD, Manola JB, et al. (2007) CT and PET: early prognostic indicators of response to imatinib mesylate in patients with gastrointestinal stromal tumor. AJR Am J Roentgenol 189(6):W324–330. doi:10.2214/AJR.07.2496
Taxy JB, Battifora H (1988) Angiosarcoma of the gastrointestinal tract. A report of three cases. Cancer 62(1):210–216
Restrepo CS, Martinez S, Lemos JA, Carrillo JA, Lemos DF, Ojeda P, Koshy P (2006) Imaging manifestations of Kaposi sarcoma. Radiographics 26(4):1169–1185. doi:10.1148/rg.264055129
Ghai S, Pattison J, Ghai S, O’Malley ME, Khalili K, Stephens M (2007) Primary gastrointestinal lymphoma: spectrum of imaging findings with pathologic correlation. Radiographics 27(5):1371–1388. doi:10.1148/rg.275065151
Ferrucci PF, Zucca E (2007) Primary gastric lymphoma pathogenesis and treatment: what has changed over the past 10 years? Br J Haematol 136(4):521–538. doi:10.1111/j.1365-2141.2006.06444.x
Campoli PM, Ejima FH, Cardoso DM, et al. (2006) Metastatic cancer to the stomach. Gastric Cancer 9(1):19–25. doi:10.1007/s10120-005-0352-5
Mesa H, Rawal A, Rezcallah A, et al. (2009) “Burned out” testicular seminoma presenting as a primary gastric malignancy. Int J Clin Oncol 14(1):74–77. doi:10.1007/s10147-008-0804-0
Yamamoto H, Deshmukh N, Gourevitch D, et al. (2007) Upper gastrointestinal hemorrhage as a rare extragonadal presentation of seminoma of testis. Int J Urol 14(3):261–263. doi:10.1111/j.1442-2042.2007.01685.x
Coskun M, Agildere AM, Boyvat F, Tarhan C, Niron EA (1998) Primary choriocarcinoma of the stomach and pancreas: CT findings. Eur Radiol 8(8):1425–1428
Guilford P, Hopkins J, Harraway J, et al. (1998) E-cadherin germline mutations in familial gastric cancer. Nature 392(6674):402–405. doi:10.1038/32918
Rogers WM, Dobo E, Norton JA, et al. (2008) Risk-reducing total gastrectomy for germline mutations in E-cadherin (CDH1): pathologic findings with clinical implications. Am J Surg Pathol 32(6):799–809. doi:10.1097/PAS.0b013e31815e7f1a
National Comprehensive Cancer Network (NCCN) Gastric Cancer (Version 1.2014). 2014
Brosens LA, Langeveld D, van Hattem WA, Giardiello FM, Offerhaus GJ (2011) Juvenile polyposis syndrome. World J Gastroenterol WJG 17(44):4839–4844. doi:10.3748/wjg.v17.i44.4839
van Lier MG, Wagner A, Mathus-Vliegen EM, Kuipers EJ, Steyerberg EW, van Leerdam ME (2010) High cancer risk in Peutz-Jeghers syndrome: a systematic review and surveillance recommendations. Am J Gastroenterol 105(6):1258–1264; author reply 1265. doi:10.1038/ajg.2009.725
Capelle LG, Van Grieken NC, Lingsma HF, et al. (2010) Risk and epidemiological time trends of gastric cancer in Lynch syndrome carriers in the Netherlands. Gastroenterology 138(2):487–492. doi:10.1053/j.gastro.2009.10.051
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Author C.S.F. is supported by GI SPORE Grant # P50CA127003.
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Richman, D.M., Tirumani, S.H., Hornick, J.L. et al. Beyond gastric adenocarcinoma: Multimodality assessment of common and uncommon gastric neoplasms. Abdom Radiol 42, 124–140 (2017). https://doi.org/10.1007/s00261-016-0901-x
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DOI: https://doi.org/10.1007/s00261-016-0901-x