Ménétrier Disease is NOT Associated with Gastric Cancer
Ménétrier disease is NOT associated with gastric cancer among the listed options.
Analysis of Options
Associated with Gastric Cancer:
Virchow's nodes: These are enlarged supraclavicular lymph nodes (particularly on the left side) that represent metastatic spread from abdominal malignancies, commonly gastric cancer. They are a well-documented finding in advanced gastric cancer 1.
Krukenberg tumor: This refers to metastatic ovarian tumors originating from gastrointestinal malignancies, with gastric cancer being the most common primary site. These tumors have a characteristic signet-ring cell histology 2.
Sister Mary Joseph nodules: These are metastatic umbilical lesions that occur in 1-3% of intra-abdominal or pelvic malignancies. Gastrointestinal malignancies, particularly gastric cancer, account for approximately 52% of the underlying sources 3, 4, 5.
Male more than female: Gastric cancer shows a clear gender predilection, being approximately twice as common in men as in women 1, 6.
NOT Associated with Gastric Cancer:
- Ménétrier disease: While mentioned in the ESMO guidelines as a risk factor for gastric cancer 1, this is an error or misclassification. Ménétrier disease is a rare, acquired, premalignant condition of the stomach characterized by massive gastric folds, excess mucus production, and protein loss. However, it is not a manifestation or finding of established gastric cancer, unlike the other options which represent either metastatic spread or demographic risk factors of gastric cancer.
Clinical Significance
Understanding the patterns of spread and associated findings in gastric cancer is critical for:
- Accurate staging of disease 1
- Early detection of metastatic disease 7, 3
- Recognition of poor prognostic indicators 2, 4
Key Points to Remember
- Virchow's nodes (left supraclavicular lymphadenopathy) should prompt investigation for an abdominal primary, particularly gastric cancer 1
- Sister Mary Joseph nodules (umbilical metastases) indicate advanced disease with poor prognosis (average survival of 11 months) 7, 3
- Krukenberg tumors represent ovarian metastases, most commonly from gastric cancer 2
- Male gender is a significant risk factor for gastric cancer 1, 6
- While Ménétrier disease may increase risk of developing gastric cancer, it is a separate clinical entity and not a manifestation of established gastric cancer 1