Small growths in the immediate vicinity of the cardiac orifice can never be detected by palpation, but should they extend to the lesser curvature or to the fundus of the stomach they may give rise to definite tumours. Carcinoma of the fundus usually produces a mass which is located in the left hypochondrium, and which at first can be felt only on deep inspiration or after inflation of the stomach. At a later period it often projects below the costal margin and extends towards the umbilicus. In most instances the growth is particularly rapid, great tenderness is present, and the surface of the tumour is nodular, owing to an implication of the omentum. General cancerous peritonitis is apt to follow disease of this region of the organ and to obscure the original growth; while not infrequently the mass becomes fixed to the abdominal wall or to the costal cartilages.

Fig. 45.- Showing the forms of tumour which may be met with in disease of the cardia and fundus.