Gastric adenocarcinoma may spread via direct extension through the stomach wall into adjacent organs (spleen, pancreas, colon, esophagus, diaphragm) Alternatively, cancer cells may spread through lymphatic channels to lymph nodes in the abdomen or chest, and even rarely to the left supraclavicular (neck) lymph nodes. Metastases through the bloodstream can result in the cancer spreading to distant organs such as liver, lungs, and bones. Direct peritoneal seeding can produce malignant ascites (fluid accumulation in the abdomen) In women, stomach cancer can spread to the ovaries, referred to as a Krukenberg tumor.
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