Which of the following features on endoscopy and histology is MOST consistent with a malignant gastric ulcer rather than a benign peptic ulcer?

• A Ulcer at the junction of the body and antrum, with sloping margins and surrounding oedema
• B Ulcer that heals completely after 6-week proton pump inhibitor therapy
• C Ulcer on the lesser curvature with heaped-up, irregular, overhanging margins and nodular surrounding mucosa ✓
• D Benign gastric ulcer never occurs on the lesser curvature

Explanation

Malignant gastric ulcers characteristically have heaped-up, irregular, overhanging ('rolled') edges with a necrotic base and surrounding nodular or thickened mucosa — due to infiltration by tumour. Benign peptic ulcers typically have smooth, punched-out edges with sloping margins and a clean base. Complete healing after PPI therapy favours benignity but does not exclude malignancy — all gastric ulcers require biopsy and follow-up endoscopy to confirm healing.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.