Differences Between Benign and Malignant Gastric Ulcers

To accurately distinguish between benign and malignant gastric ulcers, a biopsy of the affected tissue is required. Below are the key differences:

Benign Gastric Ulcer:
A benign ulcer typically appears small with a clean, flat base. This characteristic is often described as "small mouth, flat bottom, and clean exudate." The surrounding mucosa may show signs of regenerative epithelium and can be accompanied by mild edema or hyperemia. These ulcers are usually round or oval in shape and tend to develop outside the normal gastric contour, forming on the regular structure of the stomach wall.

Malignant Gastric Ulcer:
In contrast, malignant ulcers often occur in atypical locations within the stomach. While gastric ulcers commonly appear near the gastric angle, cancerous ulcers may develop elsewhere. These ulcers are generally larger than 2 cm, with an irregular shape and an uneven, eroded, or bleeding base. The surrounding mucosa may show significant edema, and the ulcer itself tends to be deep, sometimes even penetrating through all layers of the stomach wall. During biopsy, the tissue feels fragile, which is another sign of malignancy.