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'''Malignant''' tumours include:

Gastric [[Neoplasia - Pathology|neoplasia]] is uncommon and represents less than 1% of neoplasia in small animals. Aetiology is largely idiopathic though long term ingestion of dietary carcinogens may have some responsibility. In humans, ''Helicobacter pylori'' can induce gastric carcinomas and lymphomas. Its role in gastric tumours in dogs and cats has not yet been fully established though it is known to cause [[Gastritis, Acute|gastritis]] and [[Gastric Ulceration - all species|ulceration]]. Belgian Shepherd dogs may have a genetic predisposition to gastric carcinomas. Cats with gastric lymphomas are usually FeLV positive.

* [[Adenocarcinoma|Adenocarcinoma]] - 70-80% of all canine gastric neoplasms

* [[Adenocarcinoma|Adenocarcinoma]] - 70-80% of all canine gastric neoplasms

* [[Squamous Cell Carcinoma|Squamous Cell Carcinoma]]

* [[Squamous Cell Carcinoma|Squamous Cell Carcinoma]]

* Mast cell

* Mast cell

* Gastrointestinal stromal tumours (GIST tumours) - 20% of these tumours occur in the canine stomach

* Gastrointestinal stromal tumours (GIST tumours) - 20% of these tumours occur in the canine stomach

Benign tumours include:

 

'''Benign''' tumours include:

* Polyps

* Polyps

* [[Leiomyoma|Leiomyoma]]

* [[Leiomyoma|Leiomyoma]]

==Signalment==

==Signalment==

Male dogs are more commonly affected than female: e.g male:female ratio in those with carcinoma 2.5:1  

Male dogs are more commonly affected than female: e.g male:female ratio in those with carcinoma 2.5:1  

The mean age of dogs with carinomas is 8 years and cats with carcinomas are usually over 10 years. For benign tumours the mean age of affected dogs is 15 years.

The mean age of dogs with carcinomas is 8 years and cats with carcinomas are usually over 10 years. For benign tumours the mean age of affected dogs is 15 years.

==Diagnosis==  

==Diagnosis==  

===History and Clinical Signs===

===History and Clinical Signs===

May be mild or non-specific early on in the disease process.

Clinical signs may be mild or non-specific early on in the disease process.

Often a history of Chronic [[Vomiting|vomiting} - blood tinged/'coffee grounds' appearance (partially digested blood, Weight loss, Anorexia and Maleana/occult faecal blood.

Often a history of Chronic [[Vomiting|vomiting} - blood tinged/'coffee grounds' appearance (partially digested blood, weight loss, asnorexia and maleana/occult faecal blood.

Anterior abdominal pain may or may not be present

 

Anterior abdominal pain may or may not be present.

 

 

 

'''Plasmacytoma''': metastasis is frequently evident in local lymph nodes.

Plasmacytoma: metastasis is frequently evident in local lymph nodes.

===Haematology and biochemistry===

===Haematology and biochemistry===

A Regerative anaemia may be present due to gastric haemorrhage. [[Electrolytes|Electrolyte]] disturabnces will be evident following vomiting and also elevated [[Urea|BUN]] and creatinine levels due to [[Dehydration - Pathology|dehydration]].

A Regenerative anaemia may be present due to gastric haemorrhage. [[Electrolytes|Electrolyte]] disturabnces will be evident following vomiting and also elevated [[Urea|BUN]] and creatinine levels due to [[Dehydration - Pathology|dehydration]].

If hepatic metastasis has occured or if there is obstruction to the common bile duct hepatic enzymes will also be increased.

 

If hepatic metastasis has occurred or if there is [[Bile dict - Obstruction|obstruction to the common bile duct]] hepatic enzymes will also be increased.

 

Hypercalcaemia may be evident if lymphoma is present. Hypoglycaemia can also be associated with leiomyomas and leiomyosarcomas and is potentially reversibe following tumour resection.

===Positive Contrast Radiography===

===Positive Contrast Radiography===

===Surgical Biopsy===

===Surgical Biopsy===

Alternatively, biopsies can be taken via gastrotomy at the time of surgical treatment (see below). If a GIST is susptected a CD117 immunohistochemical stain can be used for diagnosis (in half of all dogs affected GIST tumours express CD117 (c-kit), a tyrosine kinase receptor).

Alternatively, biopsies can be taken via gastrotomy at the time of surgical treatment (see below). If a GIST is susptected a CD117 immunohistochemical stain can be used for diagnosis (in half of all dogs affected GIST tumours express CD117 (c-kit), a tyrosine kinase receptor).

==Treatment==

==Treatment==

===Surgery===

===Surgery===

Prior to any surgical intervention thoracic radiography should be performed for evidence of metastasis. Regional lymph nodes should also be examined at the start of surgery along with the rest of the abdominal cavity. For tumours that have not metastasised, resection is the treatment of choice (wide partial gastrectomy or antrectomy with gastroduodenostomy. However, frequently there are  difficulties as tumours are often in an advanced stage at time of presentation.  

Prior to any surgical intervention thoracic radiography should be performed for evidence of metastasis. Regional lymph nodes should also be examined at the start of surgery along with the rest of the abdominal cavity. For tumours that have not metastasised, resection is the treatment of choice (wide partial gastrectomy or antrectomy with gastroduodenostomy. However, frequently there are  difficulties as tumours are often in an advanced stage at time of presentation.  

Excision with large margins whilst maintaining the ability to sucessfully reconstruct the stomach without post-operative complications can be problematic. Futhermore, pylorectomy and gastroduodenostomy or gastrojejunostomy for antral tumours risk iatrogenic trauma to the local blood supply as well as to the pancreas and extrahepatic biliary system.  

 

Excision with large margins whilst maintaining the ability to successfully reconstruct the stomach without post-operative complications can be problematic. Furthermore, pylorectomy and gastroduodenostomy or gastrojejunostomy for antral tumours risk iatrogenic trauma to the local blood supply as well as to the pancreas and extrahepatic biliary system.  

 

Neoplasia associated with the lesser curvature is generally non-resectable.

Neoplasia associated with the lesser curvature is generally non-resectable.

==References==

==References==

Morris J, Dobson J (2001) Gastrointestinal Tract, in Small Animal Oncology, Blackwell Science, pp 127-130                                   

Morris J, Dobson J (2001) '''Gastrointestinal Tract, in Small Animal Oncology''', ''Blackwell Science'', pp 127-130                                   

Liptak J. M, Withrow S.J, (2007), Cancer of the Gastrointestinal Tract, in Withrow and MacEwen's Small Animal Clinical Oncology, fourth edition. Saunders Elsevier, pp 480-482

Liptak J. M, Withrow S.J, (2007), '''Cancer of the Gastrointestinal Tract, in Withrow and MacEwen's Small Animal Clinical Oncology''', fourth edition. ''Saunders Elsevier'', pp 480-482

 

 

[[Category:Stomach_and_Abomasum_-_Proliferative_Pathology]][[Category:To_Do_-_Caz]]

[[Category:Stomach_and_Abomasum_-_Proliferative_Pathology]][[Category:To_Do_-_Caz]]

[[Category:Neoplasia]]

[[Category:Neoplasia]]

[[Category:Dog]][[Category:Cat]]

[[Category:Dog]][[Category:Cat]]

[[Category:To_Do_-_Review]]

[[Category:Expert_Review]]