Which of the following statement(s) is/are correct regarding gastric ulcers greater than 3 cm in size?

b. The risk of malignancy increases with increasing size of the ulcer

c. The treatment of choice for giant gastric ulcer is resection to include the ulcer

A giant gastric ulcer is defined as an ulcer whose diameter is 3 cm or greater. The lesser curvature is the most common site, with only 3% to 4% occurring along the greater curvature. Gastric ulcers often penetrate into contiguous structures such as spleen, pancreas, liver, and transverse colon, and can be falsely diagnosed as a nonresectable malignancy, despite normal biopsy results. Most reports cite an incidence of malignancy ranging from 6% to 30%, increasing with the size of the ulcer. Because of the high likelihood of complications from giant gastric ulcer, early operation is the treatment of choice. The operation of choice is resection, including the ulcer. If the ulcer has penetrated adjacent structures and cannot be dissected free, the stomach wall can be incised circumferentially, leaving the ulcer intact and behind, and the gastric resection completed.