Gastric tumours

Gastric tumours are either epithelial or stromal in origin. Benign tumours are rare, whereas the majority are malignant and mostly adenocarcinomas. Gastric lymphomas, gastrointestinal stromal tumours (GISTs) and gastric carcinoid tumours are less common and have variable cancer biology. Benign gastric adenomas and GISTs may be asymptomatic and found incidentally, although they may be complicated by acute gastrointestinal haemorrhage. Simple excision is usually required. Gastric adenocarcinoma is the eighth commonest cancer in the UK. Proximally situated cancers are most frequent. Recognition of early gastric cancer remains a challenge in low-incidence areas. Improvements in imaging techniques have allowed more individualized, tailored and stage-related treatments. Locally advanced cancer requires radical surgical excision yet overall survival remains poor. Outcome in localized cancers is improved by multi-modality therapies. Gastric lymphomas are the commonest gastrointestinal tract lymphoma and most arise from mucosa-associated lymphoid tissue. These are low grade but may progress to high-grade lymphomas. GISTs usually have a benign biology although a third can be locally invasive and metastasize. The tumour cells express c-KIT, a growth factor receptor with tyrosine kinase activity, which is susceptible to targeted therapy.