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Metastatic patterns of stomach cancer

Spreading occurs in different patterns:

  • Spreading by direct invasion of other organs, often the pancreas, possibly transverse colon or left liver lobe.
  • Spreading to the peritoneum or infiltration of serosa. In women, isolated metastases can develop in the ovaries (Krukenberg tumor).
  • Hematogenic spreading usually to the liver and more seldomly to the lungs or bone.
  • Lymphatic spreading to lymph nodes along in the hepatic duodenal ligament, along the celiac trunk and the splenic vessels. Stomach cancer rarely spreads to lymph nodes in the supraclavicular fossa (Wirchow).

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