PAEA Surgery End Of Rotation (EOR) Practice Exam

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Which sign is associated with metastatic gastric cancer to the left supraclavicular fossa?

Sister Mary Joseph's sign
Virchow's node
Krukenberg's tumor
Blumberg's sign

The correct answer is: Virchow's node

Virchow's node, which is the left supraclavicular lymph node, is associated with metastatic gastric cancer. The presence of a palpable left supraclavicular lymph node signifies potential malignancy in the abdominal cavity, particularly from the stomach. This phenomenon occurs because lymphatic drainage from the abdominal organs can lead to the spread of cancer cells to this node, making it a sentinel site for detecting gastrointestinal malignancies, including gastric cancer. Sister Mary Joseph's sign refers to a palpable nodule in the periumbilical region indicating intra-abdominal malignancy, while Krukenberg's tumor specifically refers to ovarian metastasis usually arising from gastric cancer but does not directly relate to the supraclavicular area. Blumberg's sign involves rebound tenderness that indicates peritoneal irritation and is not specific for any type of metastatic cancer but rather reflects acute abdominal conditions. In this context, Virchow's node serves as a clear marker related to metastatic gastric cancer, demonstrating the lymphatic spread of the disease and its clinical significance in diagnosis.