A clinicopathologic study of large benign gastric ulcers
Turner, J.C.; Dockerty, M.B.; Priestley, J.T.; Comfort, M.W.
Surgery Gynecology and Obstetrics 104(6): 746-750
1957
ISSN/ISBN: 0039-6087 PMID: 13455380 Document Number: 8107
This is a report of the results of a clinicopathologic study of 100 cases of benign gastric ulcer 4 centimeters or more in diameter encountered at the Mayo Clinic. These cases constituted approximately 4 per cent of the cases of benign gastric ulcer treated surgically during the 15 year period 1940 through 1954. The most significant clinical observation was the ability of the large benign gastric ulcer to simulate carcinoma, which points up the need for the clinician, the radiologist, and the surgeon to become aware of and to recognize the entity of such ulcers. Although there is a definite correlation between the size of an ulcer and the likelihood of its being malignant, size alone, no matter how suggestive, is not an absolute criterion of malignancy in the individual case, as evidenced by the cases in this report. However, since the incidence of benignancy among gastric lesions whose longest diameter measures 4.0 centimeters or more is so low, immediate surgical therapy is advisable. Unfortunately, a large benign gastric ulcer cannot always be distinguished from a malignant one by clinical means and by palpation at the time of operation. Nevertheless, when the surgeon finds a large gastric ulcer on the lesser curvature or the posterior wall, or both, without obvious signs of malignancy, he should not consider the lesion to be malignant because of its size alone. Further, the lesion should be treated by subtotal gastric resection if possible.
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