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Flashcards in GI: Common GI malignancies Deck (16)
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1
Q

How common is oesophageal carcinoma?

What is the prognosis of oesophageal carcinoma?

A

2% of malignancies in UK - More common in males

Usually presents as advanced disease and can spread directly through the oesophageal wall
Very poor prognosis - 5% 5yr survival

2
Q

How does oesophageal carcinoma present?

How would you investigate it?

A

Progressive dysphagia - may start with dry foods, then all foods, then liquids
Weight loss
Investigate using endoscopy and biopsy

3
Q

What are the 2 types of oesophageal carcinoma?

A

Squamous cell carcinoma: most common, can occur at any level

Adenocarcinoma: uncommon, occurs in the lower third and associated with barretts oesophagus

4
Q

How common is gastric cancer and what is the prognosis?

A

Very common - 15% of cancer deaths world wide

Poor prognosis and more common in men, Associated with gastritis from H Pylori

5
Q

How does gastric cancer present?

A

Often presents with vague symptoms - epigastric pain, vomiting (due to obstruction), weight loss

6
Q

What are the microscopic features of gastric cancer?

A

Intestinal - variable gland formation

Diffuse - single cells and small groups, get signet ring cells that are full of mucin

7
Q

How can gastric cancer spread?

A
  • directly through the gastric wall
  • via lymph nodes
  • trans coelomic eg in peritoneum and ovaries
8
Q

How is gastric cancer treated?

A

Surgery, chemotherapy, herceptin (used palliatively, same genetic abnormality seen in breast cancer)

9
Q

Describe the features of large intestinal adenomas

A

They are always dysplastic and have definite malignant potential - increased risk of neoplasia even if removed
Increase with age
Some people have genetic syndromes which predispose to adenomas

10
Q

What genetic condition predisposes to large intestinal adenoma?

A

Familial adenomatous polyposis - an autosomal dominant condition where there are thousands of adenomas by 20yrs with each having potential to turn cancerous
Need to have prophylactic colectomies

11
Q

Where is the most common location for colorectal adenocarcinoma?

A

70% are in the sigmoid colon or rectum

12
Q

How can colorectal adenocarcinoma spread?

A

Directly through the bowel wall to adjacent organs eg bladder
Via lymphatics to mesenteric lymph nodes
Via the portal venous system to the liver

13
Q

How is colorectal adenocarcinoma staged?

A

Duke’s staging system
A = confined to bowel wall
B = through wall but lymph nodes clear
C = lymph nodes involved

14
Q

What are the causes of colorectal adenocarcinoma?

A

Low fibre diet
Slow transit time - more contact time for bad substances
High fat intake
Genetic predisposition

15
Q

Where is the pancreas in carcinoma most likely?

A

2/3 of pancreatic cancers are in the head

16
Q

What are the most common liver malignancies?

A

Most commonly metastatic

Most common primary malignancy is hepatocellular carcinoma - associated with cirrhosis and viral hep C

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