A 57 year old man with blood group A complains of symptoms of vomiting, tiredness, weight loss and palpitations. Exam: hepatomegaly, ascites, palpable left supraclavicular mass. What is the most likely diagnosis?

The key is A. Gastric carcinoma. [i) blood group A is associated with gastric cancer ii) vomiting, tiredness, weight loss are general features of gastric cancer iii) palpitation from anemia of cancer iv) hepatomegaly (metastasis) and ascites are late features of gastric cancer. v) palpable left supraclavicular mass- is Vershow’s gland, has long been regarded as strongly indicative of gastric cancer].