General Considerations

  • LSA is the most common gastric tumor in cats (solitary or multicentric) and most are FeLV negative
  • Sex predisposition: males
  • Gross appearance: discrete mass or diffuse gastric wall diffusion

+ Clinical Signs

  • Clinical signs are caused by gastric outflow obstruction, altered motility, or chronic blood loss secondary to tumor necrosis and ulceration
  • Progressive vomiting is common and may contain fresh or digested blood
  • Weight loss may be caused by poor digestion, protein malnutrition, or cancer cachex

+ Laboratory Tests

  • Laboratory tests and survey radiographs are usually unrewarding
  • Leiomyoma and leiomyosarcoma have been associated with paraneoplastic hypoglycemia
  • Microcytic hypochromic anemia is common with chronic blood loss and occult blood may be detected in feces
  • Increased liver enzymes may be seen with hepatic metastasis or obstruction of the common bile duct


+ Radiographs

Positive- or double-contrast radiographs: gastric tumors can appear as a mass effect, ulcer crater, delayed gastric emptying with poor motility, and delayed adherence of contrast material to an ulcerated tumor

+ Ultrasonography

  • Ultrasonographic findings include transmural thickening of the gastric wall with loss or altered layering (poor echogenic outer and inner lining with hyperechoic central zone)
  • Other findings include tumor location, ulceration, extension through gastric wall, and lymphadenopathy
  • Gastric ADC tend to appear as sessile mass located in the lesser curvature or antrum

+ Endoscopy

  • Gastroscopy allows direct visualization and guided biopsy
  • Several biopsies should be performed as superficial ulceration, necrosis, and inflammation is common
  • Submucosal masses are difficult to biopsy and false-negative results are common

+ Other Imaging Techniques

  • CT
  • MRI


+ Surgery

  • Surgery is possibly solitary feline gastric LSA but complicated by advanced stage at presentation, frequent metastasis, difficult access, and debilitated animal
  • Lymph node metastasis is variable and all abdominal lymph node should be evaluated for staging purposes
  • Curative resection should be attempted if disease is localized to the stomach
  • Surgical techniques: Billroth I or II or palliative bypass procedures
  • Billroth I or II provides immediate relief of gastric outflow obstruction and clinical improvement in early postoperative period
  • Billroth II (partial gastrectomy and gastrojejunostomy) or complete gastrectomy (with biliary by-pass) are very extensive surgeries with high morbidity and minimal survival advantage
  • Partial gastrectomy preferred in humans due to better nutritional status and quality of life and radical gastrectomy does not improve survival time
  • Palliative gastrojejunostomy for inoperable or metastatic lesions but associated with significant morbidity including anastomotic ulcers

+ Chemotherapy

Gastric LSA does not respond well to conventional chemotherapy protocols and chemotherapy may not be required following surgical resection of solitary gastric LSA in cats

+ Prognosis

  • Prognosis depends on surgical excision, tumor type and grade, and presence of metastatic lesions
  • Gastric LSA: MST 40 weeks with Madison-Wisconsin protocol and 15.5 months with prednisolone-chlorambucil