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Clinical Medicine 2 > Lecture 8 (Lung CA)-Exam 3 > Flashcards

Lecture 8 (Lung CA)-Exam 3 Flashcards

1
Q

Pulmonary Nodule
* What size is a solitary nodule? What size is a mass?
* What size is suspicious, what size requires a work up and what size is malgnant unless proven otherwise? ⭐️
* What is the shape?
* usually incidental findings in who?
* Can be what?
* Most likely bengin in who?
* Likeihood of malignacy increas with what?

A
  • Solitary nodule <3 cm, >3 cm mass
  • > 8mm (0.8cm) is suspicious, generally 1cm or greater requires at least some work-up, >3cm is malignant unless proven otherwise ⭐️
  • Rounded opacity on CT scan, outlined by normal lung, not associated with infiltrate, atelectasis, or adenopathy
  • Usually, incidental finding in pts >=35 without symptoms
  • Can be malignant or benign
  • Most likely benign with age <30
  • Likelihood of malignancy increases with age and if smoker

under slide: Subcentimeter nodules are usually below the threshold of PET scan recognition.

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2
Q

Pulmonary Nodule: benign causes
* What are the infectious causes?
* What is the benign tumor?
* What is vascular? What do you NOT do?
* What are some other causes?

A
  • Infectious: infectious granulomas (TB) cause 80%; endemic fungi (histoplasmosis, coccidioidomycosis) and mycobacteria (TB or non-TB), most common. Less common, abscess-forming bacteria (Staph)
  • Benign tumors: pulmonary hamartomas 10%.
  • Vascular: Pulmonary arteriovenous malformations (PAVMs)->Do not biopsy (dt bleeding, so do CTa instead)
  • Other: inflammatory; granulomatosis RA, sarcoidosis, bronchogenic cyst
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3
Q

Pulmonary Nodule- Malignant causes:
* What is the primary lung cancer?
* What is the metastatic cancers?
* What are the carinoid tumors?

A
  • Primary lung cancer: Adenocarcinoma most common
  • Metastatic cancer: Most common malignant melanoma, sarcoma and carcinomas of the bronchus, colon, breast, kidney and testicle.
  • Carcinoid tumors: Although most endobronchial, approx. 20% present as a peripheral, well-circumscribed pulmonary nodule
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4
Q

Solitary Nodules-Goals of evaluation
* Identify and resect what?
* Aviod what?
* Most bengin nodules are what?
* What accounts for under 5% of solitary nodules?

A

Identify & resect malignant tumors
Avoid invasive procedures in benign nodules
* Most benign nodules are infectious granulomas
* Hamartomas (benign neoplasms) only account for < 5% of solitary nodules

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5
Q

Solitary nodules:
* What are the Factors suggesting malignancy & need for resection?

A
  • Cigarette smoking
  • Age > 35
  • Relatively large(> 2 cm) lesion
  • Lack of calcification
  • Chest symptoms
  • Growth of lesion compared to old CXR
  • Prior malignancy history increases the risk
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6
Q

Evaluation of nodule
* What is inital evaluation?
* Likeihood determines what?
* How do you asses risk?
* Often what?

A
  • Initial evaluation uses clinical and radiographic features to determine likelihood of malignancy.
  • Likelihood determines surveillance with CT or biopsy
  • Assessing risk either clinically or predictive models, calculators
  • Often intuitive
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7
Q

Evaluation of nodule
* What are the age associated risks?
* What are the other risk factors?

A

Age associated risks:
* 35 to 39 years: 3 percent
* 40 to 49 years: 15 percent
* 50 to 59: 43 percent
* ≥60 years: >50 percent

Other risk factors considered:
* Smoking
* Family history
* Female
* Emphysema
* Prior malignancy
* Asbestos

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8
Q

Pulmonary Nodule Characteristics
* What should you review?
* What is likely infection?
* Growth: what suggests benign? What is growth defined as?
* What are the size and malignancy rates (4)

A
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9
Q

Pulmonary Nodule Characteristics
* What is a characterisitcs of a benign process?
* What characterisitic suggests malignancy?
* What is highly associated malignancy on CT
* What type of pattern is in bengin nodules?
* What type of pattern is in malignant nodules?
* What types of walls are more likely malignant?

A
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10
Q

Evaluation of Pulmonary Nodules
* What are low probability patients? What do you need to do for work up?
* What are intermediate probability patients? What do you need to do for work up?
* What are high probability patients? What do you need to do for work up?

A
  • Low probability patients: age under 30, lesions stable for more than 2 years, characteristic pattern of benign calcification -> watchful waiting with serial CT scans or CXR
  • Intermediate probability patients -> biopsy via bronchoscopy or CT guided biopsy
  • High probability patients -> surgical resection (if surgical risk is acceptable).
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11
Q

Lung Cancer
* Leading cause of what?
* What is the genetic predisposition?
* Most people are how old at dx?
* Combined relative 5-year survival rate for all stages is what?

A
  • Leading cause of cancer deaths in both men (>40yo) and women (>60yo) in US-> Surpassed breast CA in 1987
  • Genetic Predisposition: ATM, CXCR2, CYP1A1, CYP2E1, ERCC1, ERCC2, FGFR4, SOD2, TERT, and TP53
  • Most people over 65 at time of diagnosis in US; average 70, unusual under the age of 40
  • Combined relative 5-year survival rate for all stages is currently 19%
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12
Q

Risk Factors of lung cancer:
* What is the primiary risk factor of cancer? ⭐️⭐️⭐️⭐️
* What are some other ones?

A

KNOW CIGSSSSSS

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13
Q

Risk factors of lung cancer:
* What are the comorbid conditions?
* What are the infections?
* What is the diet?

A
  • Comorbid conditions: COPD, Alpha1-antitrypsin
  • Infections: HPV, EB virus, CMV, HIV, chlamydia pneumonia
  • Diet: red meat, dairy products, saturated fats, and lipids have been suggested to increase the risk for lung cancer.
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14
Q

Uncertain or unproven effect on lung cancer risk: Marijuana
* Marijuana smoke contains what?
* Inhaled deeply and held for a long time, gives what?
* Due to illegal in many places, may not be possible to what?

Uncertain or unproven effect on lung cancer risk:
* What is a cig alternative?

Uncertain or unproven effect on lung cancer risk:
* What type of powder ? why?

A
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15
Q

⭐️⭐️⭐️

What is the most common independ risk factor for lung CA after smoking?

A

COPD
* Most common independent risk factor for Lung CA after smoking
* Most COPD from smoking; however, independent risk factor
* 2-to-5-fold increase in risk of lung CA

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16
Q

⭐️

Pul fibrosis increases the risk of lung cancer by how much?

A

Pulmonary fibrosis
* Fivefold increase in lung CA in pts with IPF; independent from smoking
* (more people have COPD for statistical comparison

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17
Q

What is the median age of a patient being dx with lung cancer?

A
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18
Q

Five Main Histologic Categories of Bronchogenic Carcinoma

A
  • Squamous cell
  • Adenocarcinoma
  • Adenocarcinoma in situ (previously bronchioalveolar cell carcinoma)
  • Large cell carcinoma
  • Small cell carcinoma
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19
Q

⭐️⭐️⭐️

For purposes of staging and treatment, bronchogenic carcinomas are divided into two categories, what are they?

A

Small cell lung cancer (SCLC)

Non-small cell lung cancer (NSCLC)
* Squamous cell, adenocarcinoma, adenocarcinoma in situ, Large cell carcinoma
* 80-85% of lung CA is NSCLC

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20
Q

Adenocarcinoma
* Common or rare?
* Arises from what?
* How does it present in the lungs?⭐️
* What is Adenocarcinoma in situ?

A
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21
Q

Adenocarcinoma
* Who does it often occur more in?
* Said to occur in association with what?
* Grows fast or slow? What is the prognosis?

A
  • Occurs more often in non-smokers & in smokers who have quit.
  • Said to occur in association with old trauma, scars, TB & infarctions
  • Grows more slowly than SCC or undifferentiated carcinomas & tends to have a better prognosis
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22
Q

Bronchioalveolar Carcinoma
* Varient of what?
* What does it present as?
* What is in large ares of the lung parenchyma?
* Better or worst prognosis?

A
  • Variant of adenocarcinoma, arising from epithelium of distal bronchioles.
  • Clinical picture & imaging mimic pneumonia
  • Intra-alveolar spreading, infiltrates large areas of lung parenchyma
  • Better prognosis than most other primary lung cancers.
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23
Q

Squamous Cell Carcinoma (Epidermoid cell)
* Arises from what?
* Most closely associated with what? ⭐️
* Usually presents how? ⭐️

A
  • Arise from the bronchial epithelium and often present as intraluminal masses
  • Most closely associated with cigarette smoking in men
  • Usually centrally located and can present with hemoptysis

23% of cases

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24
Q

Epidermoid Cancer Obstructing R Bronchus
* Frequently silent until it causes what?
* Amendable to early detection (sputum) due to what?

A
  • Frequently silent until it causes narrowing of bronchi, collapse of parenchyma with obstruction, & consequent pneumonia distal to obstruction
  • Amendable to early detection (sputum) due to tendency to originate in central bronchi.
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25
Q

Large Cell Carcinoma (Anaplastic)
* What is that?
* Typically what? Good or bad prognosis?
* Present how?
* What make up about 14% of cases?

A
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26
Q

Small Cell Carcinoma
* Almost always associated with what? ⭐️⭐️⭐️
* Tumors of bronchial origin that typically begin how?
* Aggressive cancers that often involves what?
* Often associated with what?
* More amenable to what?

A

do biospy-> ID cancer type-> pick therapy type

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27
Q

Histological Classification/Clinical Utility
* Small cell versus non-small cell types major determinant of what?
* What is the difference between small cell and non-small on?
* Epidermoid amendable to what? Why?
* Epidermoid & large cell cavitate in how many patients?
* Adenocarcinoma & large cell tend to originate how?

A
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28
Q

Clinical Manifestations of Lung cancer
* Over half of patients diagnosed with lung cancer present with what?
* Majority present with signs and symptoms or laboratory abnormalities that can be attributed to what?
* Hx of?

A
  • Over half of patients diagnosed with lung cancer present with locally advanced or metastatic disease at time of diagnosis
  • Majority present with signs and symptoms or laboratory abnormalities that can be attributed to the primary lesion, local tumor growth, invasion or obstruction of adjacent structures
  • History of chronic cough, hemoptysis, wheeze, stridor, dyspnea, or postobstructive pneumonia
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29
Q

Physical Exam of lung cancer
* Lung:
* HEENT:
* Fundi:
* Cardiac:
* Abdomen:
* Lymph

A
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30
Q

Signs and Symptoms on Presentation
* What happens to the pt’s weight?
* New what?
* Cough?
* What type of pain?

A
  • Anorexia, weight loss in 55-90%
  • New cough or change in chronic cough 60%
  • Hemoptysis 6-31%
  • Pain* 25-40%
    * Nonspecific chest pain
    * Pain from bony metastases to the vertebrae, ribs, or pelvis
    * Remember this with pts presenting with bony pain and no trauma
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31
Q

Signs and Symptoms on Presentation of lung cancer:
* Local spread may cause what?

A
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32
Q

What are these?

A
  • Right: pleural effusion
  • left: pericardial effusion
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33
Q

Superior Vena Cava Syndrome
* What is this?
* What are the sxs?
* Treatable if what?

A
  • Blood flow through the SVC is blocked or compressed
  • Face/neck swelling, distended neck veins, cough, dyspnea, orthopnea, upper extremity swelling, distended chest vein collaterals, and conjunctival suffusion.
  • Treatable if able to relieve compression
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34
Q

What is this?

A

SVC Syndrome

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35
Q

Symptoms metastaes to liver and brain?

A
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36
Q

What are the primary sites of metastasis?

A
  • Liver
  • Bone
  • Adrenal
  • Brain
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37
Q

Paraneoplastic Syndromes
* What is it?
* Occurs in who?
* When can it occur?
* Recognition is important because why?

A
  • Patterns of organ dysfunction related to immune-mediated or secretory effects of neoplasms
  • Occur in 10-20% of lung cancer pts
  • May precede, accompany or follow diagnosis of Lung Cancer
  • Recognition is important because treatment of the primary tumor may improve or resolve symptoms even when the cancer is not curable
38
Q

Paraneoplastic Syndromes
* What are the different one and which cancers are they more common in?

A
39
Q

What is this?

A

clubbing

40
Q

⭐️⭐️⭐️⭐️

Lambert-Eaton Myasthenic Syndrome
* What is the pathophysio?
* What is the sx?
* If you know the clinical features early then you may do what?

A
41
Q

Diagnosing LEMS
* How can you tell clinically?
* How is it tricky?
* LEMS occurs ouside of what?
* Associated with what?
* What is depressed or absent?
* What are some sxs?

A
42
Q

⭐️⭐️⭐️⭐️

Unique Feature of LEMS
* What is Postexercise facilitation?
* Therefore – reflexes and muscle testing best done when?
* This feature may lead clinicians to suspect what?

A
  • Postexercise facilitation – recovery of lost deep tendon reflexes and improvement in muscle strength with vigorous brief muscle activation
  • Therefore – reflexes and muscle testing best done after a period of rest
  • This feature may lead clinicians to suspect malingering
43
Q

How does LEMS manifest?

A
  • Abnormal gait
  • Hard to stand from sitting position
  • Difficulty in climbing, or coming down the stairs
  • Muscle testing may not match with functional loss
  • Typically symmetrical, but may be regional
44
Q

Pancoast Syndrome?

A
45
Q

Pancoast syndrome
* Rare type of what?
* Where is pain?
* What type of syndrome? ⭐️⭐️⭐️⭐️
* What happens to hand muscles?
* Most commonly caused by what?

A
46
Q

What is Horner’s syndrome?

A

Horner’s syndrome (inferior cervical ganglion) – enophthalmos, ptosis, miosis, unilateral anhydrosis

Clinical Manifestations of Lung Cancer

47
Q

Radiographic Findings of pancoast’s syndrom?

A

Radiographic Findings/Superior Sulcus Tumor
* Pancoast’s syndrome (local extension with CN VIII and T1/2 involvement) – shoulder pain with ulnar distribution

48
Q

Screening of lung cancer:
* There is research that indicates CT screening of high-risk patients (active smokers) improves what?
* What is the diagnosis txt?
* No lung cancer screening test has yet been shown to prevent what?

A
  • There is research that indicates CT screening of high-risk patients (active smokers) improves morbidity and mortality, likely due to early detection.
  • LDCT: low-dose computed tomography (yearly)
  • No lung cancer screening test has yet been shown to prevent people from dying of this disease.
49
Q
A
50
Q

Imaging for lung cancer:
* 85% are what at time of dx?
* Nearly all patients with lung cancer have what?
* Rarely what?
* May request CT scan of chest if what? ⭐️⭐️⭐️

A
  • 85% are symptomatic at time of diagnosis
  • Nearly all patients with lung cancer have abnormal findings on CXR or CT scan
  • Rarely specific
  • May request CT scan of chest if chest x-ray reveals potential pulmonary nodule
51
Q

Radiographic Features Suggesting Malignancy
* Absence of a benign pattern of what?
* A nodule or mass that is what?
* A nodule with what type of border?
* Size?
* Wall?

A
  • Absence of a benign pattern of calcification in detected lesion
  • A nodule or mass that is growing
  • A nodule with a spiculated or lobulated border
  • A larger lesion > 8 mm is suspicious (>3 cm is considered malignant unless proven otherwise)
  • A cavitary lesion that is thick walled
52
Q

CXR findings in Lung CA Types
* Adenocarcinoma: In who? Where are the masses?
* Small Cell Carcinoma: In who? What type of carcinoma?
* Squamous cell carcinoma commonly produces what?

A

Adenocarcinoma (people who don’t smoke)
* Commonly produces small peripheral masses.

Small Cell Carcinoma (only in smokers)
* Oat cell carcinoma (central)

Squamous cell carcinoma(Epidermoid)
* Commonly produces a hilar mass, mediastinal widening, and cavitation (central)

53
Q

CXR findings in Lung CA Types
* Mesothelioma (asbestosis): Always what? Presents with what?
* Large cell tumors: Produce what?

A

Mesothelioma (asbestosis) always fatal
* presents with pleural thickening

Large cell tumors
* Produce large peripheral masses

54
Q

⭐️⭐️⭐️⭐️⭐️

Cancer Diagnosis
* What needs to be obtained to confirm diagnosis of cancer? How does it happen?

A
55
Q

Cancer Diagnosis
* Thoracentesis: What is the sensitivity? Used in patients with what?
* Fine-needle aspiration: Aspiration of what? Also done with what?
* What are other tests?

A
56
Q

Fiberoptic Bronchoscopy
* Visual what?
* What do you need to brush?
* Lavage what?
* Direct biopsy of what?
* Blind transbronchial biopsy of what?
* FNA biopsy of what?
* Fluorescence bronchoscopy improves the ability to identify what?
* Endobronchial and transesophageal endoscopic US for what?
* Electromagnetic navigational bronchoscopy allows what?

A
57
Q

Explain the fluorescence bronchoscopy

A
58
Q

Bronchoalveolar Lavage (BAL)
* Performed during what?
* Minimally invasive method to provide information about what?

A
  • Performed during flexible bronchoscopy
  • Minimally invasive method to provide information about immunologic, inflammatory, and infectious processes taking place at the alveolar level
59
Q

Bronchoalveolar Lavage (BAL)
* Equal to what?
* What is usually adequate?
* How much saline is instilled?
* Samples how much?

A
  • Equal to open lung biopsy
  • One site is usually adequate
  • ~ 100 mL saline is instilled
  • Samples ~ one million alveoli (1.5 to 3% of lung)
60
Q

Bronchoalveolar Lavage (BAL)
* What are the different components?

A
61
Q

Lymphocyte subpopulations and immunohistochemistry
* What is it helpful for?

A

Immunofluorescent and immunocytochemical techniques helpful in the diagnosis of certain interstitial lung diseases and pulmonary lymphomas

62
Q

Essentials of Diagnosis of lung cancer
* Cough?
* What are other sxs?
* Enlarging what? what else on cxr/ct?
* Cytologic or histologic findings of lung cancer in what?

A
  • New cough or change in chronic cough
  • Dyspnea, hemoptysis, anorexia, weight loss
  • Enlarging nodule or mass; persistent opacity, atelectasis, or pleural effusion on CXR or CT scan
  • Cytologic or histologic findings of lung cancer in sputum, pleural fluid or biopsy specimen
63
Q

LUNG CANCER SCREENING
* Low dose CT to who?
* What type of swab? What does it identify?
* LIQUID BIOPSY?
* What are the genetic testing?
* FOR NSCLC THE MOST COMMON MUTATIONS WITH SPECIFIC THERAPEUTIC DRUGS?

A
64
Q

Staging of lung cancer
* Accurate staging is crucial: Provides what? (2) Standardizes what?

A
  • Provides clinician information to guide treatment
  • Provides patient with accurate information regarding prognosis
  • Standardize entry criteria for clinical trials to allow interpretation of results
65
Q

Staging of lung cancer
* the more extensive the disease=
* Surgical resection offers what?

A

Two essential principles of staging NSCLC
* The more extensive the disease, the worse the prognosis
* Surgical resection offers the best chance for cure

66
Q

Staging of lung cancer
* Staging begins with what?
* PE to exclude obvious what?
* Detailed history because why?

A

Staging begins with a thorough history and physical examination!
* PE to exclude obvious metastatic disease to lymph nodes, skin, and bone
* Detailed history because pt’s performance status is a powerful predictor of disease course

67
Q

Staging of lung cancer
* What labs

A

CBC, serum electrolytes, calcium, creatinine, liver biochemical tests, lactate dehydrogenase, and albumin

68
Q

Staging of lung cancer:
* What are the tests for antomic (where it has it spread)

A
69
Q

Staging of lung cancer
* how do you determine the physiologic stages?

A
  • Assessment of patient’s ability to withstand antitumor treatment or surgery
  • Pulmonary function tests
70
Q

Patients who smoke, they get many what along with lung cancer?

A

Patients who smoke, they get many head and neck cancers along with lung cancer.

71
Q

PET scan in Lung Cancer
* What can it show?

A

Primary lung cancer, with hilar, liver, & bone metastases.

72
Q

⭐️⭐️⭐️⭐️

TNM International Staging System:Attempts a physical description of the non-small cell neoplasm
* What is T, N, M

A
  • T describes the size and location of the primary tumor
  • N describes the presence and location of nodal metastases
  • M refers to the presence of absence of distant metastases
73
Q

⭐️⭐️⭐️

TNM stages are grouped into summary stages I-IV, these are used to guide therapy
* explain

A
  • Stage I and II are cured through surgery
  • IIIB and IV do not benefit from surgery
  • IIIA locally invasive diagnosis that may benefit from surgery in selected cases as part of multimodality therapy
74
Q

Tumor:
* What is T1, T2, T3, T4?

A
75
Q

Node
* What is N0, N1, N2, N3

A
76
Q

Metastasis
* What is M0, M1?

A
  • M0 - Local or regional disease, no distant metastases
  • M1 - Disseminated disease, distant metastases present
77
Q

Most common primary cancer sites associated with lung metastasis?

A
  • Breast
  • Colon
  • Cervix
  • Prostate
  • Head and Neck
  • Renal
78
Q

Metastatic Adenocarcinoma of Prostate
* Famous for metastasizing to lungs in what type of pattern?

A

Famous for metastasizing to lungs in a “lymphangitic” pattern in which streaks of tumor appear between lung lobules & beneath pleura in lymphatic spaces.

79
Q

SCLC Staging
* What are the two cateogories? Explain them?
* How is it staged?

A
80
Q

⭐️⭐️⭐️⭐️

Treatment Principles
* What is the txt of SCLC?
* What is the txt of early NSCLC?
* What is the of advance NSCLC?
* In considering all these procedures, need to think of what?

A
81
Q

Treatment NSCLC
* What offers the best chance for cure?
* Initial approach is to answer what two questions?
* Clinical features that preclude complete resection include what (2)?

A
82
Q

Treatment NSCLC
* What happens in Stage 1 and 2
* stage 2 and 1B are additionally recommended to do what?
* Stage IIIA have poor outcomes if what? What should they get?
* Inoperable IIA and IIIB treated with what?
* Stage IV tx with what?

A
  • Stage I and II surgical resection where possible
  • Stage II and select IB are additionally recommended to receive adjuvant chemotherapy
  • Stage IIIA have poor outcomes if treated with resection alone. They should get multimodality treatment that includes chemo, radiotherapy or both.
  • Inoperable IIA and IIIB treated with chemo and radiation therapy have improved survival
  • Stage IV tx with systemic therapy (targeted therapy, chemo, or immunotherapy) or symptom-based palliative therapy or both
83
Q

What responds better to radiation in NSCLC?

A

THE ABSENCE OF PD-L1 EXPRESSION RESPOND BETTER TO RADIATION

84
Q

What are the Contraindications to Surgery?

A
  • Extrathoracic metastases – already spread
  • SVC Syndrome
  • Phrenic nerve paralysis
  • Malignant pleural effusions
  • Mets to contralateral lung
  • Histological diagnosis of small cell cancer
85
Q

Treatment SCLC
* What is the standard mode of therapy? What are the response rates?
* Response after what?
* Remission short lived with what?
* Once dx recurred, median survival is what?
* Overall 2-year survival is what in limited and extensive?
* Thoracic radiation improves survival in what?

A
  • Combination chemotherapy (cisplatin and etoposide) is Standard mode of therapy
    * Limited-stage disease response rates are 80-90% (50-60% complete response)
    * Extensive-stage disease 60-80% (15-20% complete response)
  • Response after 6-12 weeks predicts median & long-term survival
  • Remissions short lived with a median duration of 6-8 months
  • Once dx recurred, median survival 3-4 months
  • Overall 2-year survival is 20-40% in limited-stage disease and 5% in extensive-stage disease
  • Thoracic radiation improves survival in limited SCLC given concurrently with chemo
86
Q

Treatment SCLC
* What can still happen with good response to chemo?
* Prophylactic cranial irradiation concurrently with chemo to decrease what?

A

High risk of brain mets even with good response to chemo
* Prophylactic cranial irradiation concurrently with chemo to decrease incidence of CNS dx and to improve survival with limited SCLC and extensive with excellent response to chemo

87
Q

Radiation Therapy Used For what?

A
88
Q
A
89
Q

Bronchial Carcinoid Tumors
* Classifed as what?
* Carcinoid tumors 6 x more common than what?
* Most occur as what? What are they?
* Who is affected (gender and age)

A
90
Q

Bronchial Carcinoid Tumors
* What does it secrete?
* What are the symptoms?
* What is carcinoid syndrome?

A
91
Q

Bronchial Carcinoid Tumors
* Dx with what?
* What does it look like? May be complicated by what?

A

Dx with bronchoscopy
* Pink or purple tumor in a central airway
* Well-visualized stroma
* Bx may be complicated by significant bleeding

92
Q

Bronchial Carcinoid Tumors
* How do these tumors grow?
* Complications involve what?
* Surgical excision of what?
* Prognosis?
* Most are resistant to what?

A
  • These tumors grow slowly and rarely metastasize
  • Complications involve bleeding and airway obstruction
  • Surgical excision of clinically symptomatic lesions
  • Prognosis favorable
  • Most are resistant to radiation and chemo

Clinical Medicine 2 (16 decks)

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