A stomach mass, often called a gastric lesion or abnormal growth, is a general term describing any unusual lump or swelling found within the stomach wall or its immediate surrounding area. This finding is usually detected through medical imaging or an endoscopic procedure, but it is not a specific diagnosis. It simply indicates an abnormal structure that requires further investigation to determine its exact nature. The composition, size, and location of the mass vary widely, meaning the cause can range from a harmless, non-cancerous condition to a serious malignancy.
Common Signs and Symptoms
The presence of an abnormal growth often causes symptoms commonly mistaken for less severe digestive issues, potentially delaying medical attention. A frequent complaint is persistent, vague discomfort or pain localized in the upper abdomen, particularly beneath the ribs. The mass may encroach upon the stomach’s capacity, triggering early satiety, which is a feeling of fullness after consuming only a small amount of food.
Patients frequently report chronic nausea, sometimes accompanied by vomiting, as the mass may obstruct the normal flow of food. Unexplained weight loss and loss of appetite are also common systemic signs. If the mass causes ulceration or bleeding, patients might notice dark, tarry stools, indicating blood loss in the upper gastrointestinal tract.
Benign and Malignant Types of Stomach Masses
Stomach masses fall into two broad categories: benign (non-cancerous) and malignant (cancerous). Benign masses typically do not spread, while malignant masses can invade surrounding tissues or travel to distant organs.
The most common benign masses are gastric polyps, abnormal growths arising from the inner lining. These are classified by cellular make-up. Hyperplastic polyps are the most frequent, often linked to chronic inflammation. Adenomatous polyps are less common but carry a higher risk of transforming into cancer, especially if larger than two centimeters.
Other benign lesions include lipomas (soft tumors made of fat cells) and leiomyomas (originating from smooth muscle cells). These lesions grow slowly and are usually only a concern if they cause bleeding or obstruct the stomach’s outlet.
Malignant masses are predominantly gastric adenocarcinomas, accounting for 90 to 95 percent of all stomach cancers. These develop from glandular cells in the innermost layer. Adenocarcinomas are separated into intestinal and diffuse types. The diffuse type is more infiltrative, causing the stomach wall to thicken, sometimes leading to linitis plastica.
Less common malignant masses include Gastrointestinal Stromal Tumors (GISTs) and lymphomas. GISTs originate from specialized pacemaker cells in the stomach wall, ranging from low-risk to aggressive malignancy. Gastric lymphomas, often associated with chronic bacterial infection, develop from immune system cells within the lining.
Methods Used for Diagnosis
Accurately identifying a stomach mass begins with a detailed medical history and physical examination, followed by specialized imaging and procedural tests. Initial imaging often involves a computed tomography (CT) scan of the chest, abdomen, and pelvis. This helps locate the mass, assess its size, and determine if there is evidence of spread to other organs.
The primary diagnostic procedure is an upper gastrointestinal endoscopy, known as esophagogastroduodenoscopy (EGD). During this procedure, a flexible tube with a camera is passed through the mouth for direct visualization of the stomach lining. Suspicious lesions can be closely examined, and multiple small tissue samples, or biopsies, are taken.
Microscopic analysis of the biopsy samples is the only way to definitively determine if the mass is benign or malignant and to identify the specific tumor type. If malignancy is confirmed, further staging tests determine the extent of the disease. Endoscopic Ultrasound (EUS) is often used to accurately assess how deeply the tumor has penetrated the stomach wall layers and whether nearby lymph nodes are involved. A positron emission tomography (PET) scan may also be utilized to search for distant metastases, which is crucial information for determining the overall stage of the cancer.
General Treatment Approaches
The management of a stomach mass is determined by the biopsy and staging results, specifically whether the mass is non-cancerous or malignant.
Benign Mass Treatment
For benign masses, such as small polyps or lipomas, treatment may be conservative, involving only regular endoscopic surveillance to monitor for changes. Small, well-defined lesions can often be completely removed using specialized instruments passed through the endoscope in a minimally invasive procedure.
Malignant Mass Treatment
If the mass is malignant, the treatment approach is multidisciplinary, combining several modalities. Surgery, specifically a partial or total gastrectomy to remove the tumor and surrounding tissue, is the only method offering a potential cure for localized stomach cancer. The extent of the surgery depends on the tumor’s size and location.
Chemotherapy, which uses powerful drugs to kill cancer cells, is frequently administered before and after surgery to shrink the tumor and eliminate microscopic disease. Radiation therapy, using high-energy beams, may be combined with chemotherapy to improve outcomes or manage symptoms in advanced cases. Targeted therapies, which block specific molecular pathways that fuel cancer growth, are also used for certain types of stomach cancer and GISTs.