THE PRESENCE of an early carcinoma of the stomach is usually first documented by the radiologist and remains one of his greatest daily challenges. While recent technical advances such as televised fluoroscopy, cineradiography, and 70-mm and 100-mm spot films have become available, no examination requires more skill and diligence than the upper gastrointestinal roentgenographic series. The following discussion will review the more common x-ray film findings seen in this disease.
Carcinoma of the stomach occurs in four major forms: an ulcer, a polypoid mass, an infiltrating lesion, or a combination of these.73 The role of the radiologist is twofold: first, to document the presence of the lesion including the demonstration of its roentgenographic characteristics, and second, to differentiate correctly the case of cancer from the more common forms of benign disease.
The ulcer in carcinoma usually does not project beyond the wall of the stomach; it has irregular margins,