46 - Stomach: Carcinoma

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Rodin Number: 41
E Number: 121
Donor: Osler
Date: 1878
Size (H x W cm): 18 x 19

The specimen consists of the stomach with a small portion of lower esophagus (E). There is a large carcinoma (arrows) which has ulcerated through the gastric wall revealing the adjacent liver (L).

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Comment

The case was documented in the Montreal General Hospital Reports 1880 I: 302 and as Osler's autopsy protocol (Case CCLXXXI) PDF icon rodin_oslerian_pathology_227.pdf. The patient was a 45 year-old woman who had a 5-6 month history of "well marked symptoms of C” (presumably cancer). The minimal inflammatory reaction on the surface of the liver (most of which has a smooth appearance) suggests that the large size of the gastric disruption may be related to the autopsy/specimen handling. However, Osler's autopsy protocol indicates the presence of "two quarts of turbid fluid" in the peritoneal cavity, suggesting that rupture and peritonitis had indeed occurred.

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