MALIGNANCY OF GASTRIC ULCER DISEASE

The incidence of malignant gastric ulcer in relation to benign ulcer has been investigated and is approximately 6 per cent. The diagnosis of malignant ulcer may be possible at the first examination, but repeated examinations are often necessary before malignancy is suspected. The lesser curvature of the body of the stomach is the most common site, followed closely by the region of the angulus and the pylorus. The criteria used in the past have been critically assessed and certain modifications are necessary when considering the diagnosis of a malignant ulcer. Size is a very variable feature. Convergence of rugal folds may occur and may extend up into the edge of the ulcer. Mistakes cannot be avoided when extensive fibrosis surrounds an old-standing peptic ulcer, but this possibility should not deter the radiologist from reporting the possibility of a malignant ulcer, as he will prove to be much more often correct than wrong. It is much better to operate on a benign ulcer than to miss the chance of early surgical removal of a malignant ulcer.