Cancer of the stomach : a clinical study . sy showed that the large mass was the liver. The stomachwas moderately dilated. On the posterior wall was a large oval mass,8 by 12 cm., with sharply defined edges, which were raised in centre was ulcerated. Opposite this there were firm adhesions tothe pancreas and colon. The pancreas was infiltrated, and the colonmuch thickened. 108 CANCER OF THE STOMACH It is of interest to note that a tumour of the posteriorwall may be felt after inflation, which might be supposed tointerfere with palpation. Case No. 134, already quoted, illus-trated th
Cancer of the stomach : a clinical study . sy showed that the large mass was the liver. The stomachwas moderately dilated. On the posterior wall was a large oval mass,8 by 12 cm., with sharply defined edges, which were raised in centre was ulcerated. Opposite this there were firm adhesions tothe pancreas and colon. The pancreas was infiltrated, and the colonmuch thickened. 108 CANCER OF THE STOMACH It is of interest to note that a tumour of the posteriorwall may be felt after inflation, which might be supposed tointerfere with palpation. Case No. 134, already quoted, illus-trated this point. Massive tumours of the Walls.—There are cases in whichthe extent of infiltration forms a tumour of unusual size, fillingthe upper part of the abdomen or occupying a large area in theleft hypochondrium. In the Lectures on Abdominal Tumours gives two cases at length. In Case 23 of that series, themass had been diagnosed as probably reDal by one physician, andby another as possibly a large phantom tumour in an hysterical. Fig. 24 (Case No. 91).—The upper outline is that of the lower shaded area is the palpable tumour. woman. The mass occupied a very large area. To the right itextended 2*5 cc. beyond the navel and about the same distancebelow, A sharp edge passed to the left, to a point 4 cc. above theanterior superior spine of the ilium, and this edge could betraced upwards to the tip of the last rib. It passed beneath thecostal border, and on inspiration descended three fingers was superficial, firm, and not tender. Behind there was adistinct margin to be felt, but it did not pass deeply into therenal region. There was resonance over the right side of themass. There had been very few stomach symptoms, but sub-sequently there was much vomiting and signs of sloughing and STUDY OF THE TUMOUR 109 necrosis of the tumour, which, with the rapid emaciation andcachexia, left no doubt as to the nature of the trouble. The mass may be mistaken for
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