Cancer of the Stomach in Young Patients

Abstract

Cancer of the stomach occurring in the young is frequently overlooked solely because of the age of the patient. While it is true that cancer of the stomach is generally regarded as a disease of elderly persons, the possibility of its presence should not be overlooked in obscure gastric conditions in the young. In the first decade of life it is a curiosity, but between the ages of ten and twenty it occurs as a small but definite percentage of all cases. Osler and McCrae (1) report 13 cases in the second and third decades, the ages of the patients being thirteen, fourteen, fifteen, sixteen, seventeen (4 cases), nineteen (2 cases), and twenty (3 cases). Smithies (2) reported one case in a patient aged eighteen. Marble (3) has recorded a case in a seventeen-year-old girl. Morian (5) reported from Payr9s Clinic an instance of the disease in a patient aged nineteen. It is said that the symptoms of gastric cancer in the young are similar to those of elderly patients. In the case here reported there were no gastric symptoms and the tumor was discovered only at autopsy. In the cases reported by Smithies (2) gastric symptoms were present very late in the disease and vomiting was mostly terminal. Marked obstruction and dilatation of the stomach are not described in the cases reported, nor is hemorrhage, although occult blood and tarry stools are mentioned in a few instances. Other diagnostic and clinical evidence of gastric disease is incompletely reported in many instances. Gastric analyses, reported in a few cases, showed a fairly wide range of acidity, the highest figures being obtained in the large carcinomatous ulcers. Lactic acid was reported by Smithies (2) in six cases. The apparent deficiency and, in many cases, complete lack of laboratory data, may be attributed to the fact that many of the cases presented no symptoms pointing to the stomach as the seat of disease. In some cases in which x-ray examination was made, the stomach showed evidence of malignancy, but many cases were reported or seen before this method of examination and diagnosis became universal. Morian (5), who found x-ray examination of special value, believes that this method will lead to the more frequent diagnosis of gastric carcinoma in young patients in the future.