TH7 GASTROINTESTINAL CANCERS Flashcards
(33 cards)
WORLDWIDE, MOST COMMON CANCER?
GASTRIC CANCER 4TH MOST COMMON
2ND LEADING CAUSE OF CANCER DEATH
IN WHICH GENDER IS STOMACH CANCER MORE COMMON
MEN (2:1) WOMEN
WHICH STOMACH CANCER HAS WORSE PROGNOSIS BASED ON THEIR LOCATION?
PROXIMALLY PLACED TUMOURS WORSE THAN SITE DISTALLY
DEFINE EARLY GASTRIC CANCER?
TUMOUR CONFINED TO GASTRIC MUCOSA + SUBMUCOSA
DEFINE ADVANCED GASTRIC CANCER?
DEEPER INVASION OF TUMOUR OTHER THAN GASTRIC MUCOSA + SUBMUCOSA
WHICH ARE THE VARIATION IN THE GROSS APPEARANCE OF ADVANCED GASTRIC CANCER?
- POLYPOID FUNGATING TUMOUR
- nodular polypoid surface with superficial ulceration - ULCERATING CANCER
- may look like benign gastric ulcer - SUPERFICIAL SPREADING CARCINOMA
- diffusely infiltrative over wide area
DEFINE LINITIS PLASTIC CARCINOMA?
SUB GROUP OF DIFFUSELY INFILTRATIVE GASTRIC CANCER
> extensive infiltration of submucosa + muscular layer w/ marked fibroblastic/desmoplastic reaction around columns of malignant cells
> spreads to muscles of stomach + makes it more thicker + rigid
> stomach can’t stretch as much + hold much
MOST DEFINITIVE DIAGNOSIS OF GASTRIC NEOPLASM?
FIBROPTIC ENDOSCOPY
HOW IS BENING DIFFERENTIATED FROM MALIGNANT GASTRIC ULCERS?
ONLY WITH GASTRIC BIOPSY
ACCURACY CAN EXCEED 95% WITH MULTIPLE BIOPSY SPECIMEN
WHICH FORM OF THERAPY IS CURATIVE FOR GASTRIC CANCER?
RADICAL SURGERY
WHICH IS MOST COMMON MALIGNANT TUMOUR OF SMALL BOWEL?
CARCINOID TUMOURS
WHAT IS THE ORIGIN OF CARCINOID TUMOURS?
ORIGINATE > ENTEROCHROMAFFIC CELLS
> form part of a system of neuroendocrine cells scattered throughout body
> these cells found in mucus membrane of gut near base of crypts
WHAT IS THE MOST COMMON LOCALISATION OF CARCINOID TUMOURS?
MOST COMMON > APPENDIX
FOLLOWED BY JEJENUM, RECTUM + DUODENUM
CLINICAL PRESENTATION OF CARCINOID SYNDROME?
FLUSHING
DIARRHOA
WHEEZING
> occurs when carcinoid metabolites secreted directly into circulation from hepatic metastasis
WITH WHICH OTHER DISEASE IS ADENOCARCINOMAS OF TERMINAL ILEUM MOSTLY ASSOCIATED WITH?
CROHNS DISEASE
WHAT IS THE ANATOMICAL DISTRIBUTION OF COLORECTAL CANCER?
RECTUM 57% SIGMOID COLON 21% DESCENDING COLON 3% SPLENIC FLEXURE 3% TRANSVERSE COLON 5% HEPATIC FLEXURE 2% ASCENDING COLON 3% CECUM 6%
GROSS PATHOLOGY FORMS OF COLORECTAL CANCER?
MACROSCOPICALLY COLORECTAL CX CLASSIFIED: > POLYPOID > ULCERATIVE > ANNULAR > COMBINATION OF ALL 3
WHICH METHOD IS USEFUL IN DX + PREOPERATIVE STAGING OF TUMOURS OF RECTUM?
ENDORECTAL ULTRASONOGRAPHY
MOST COMMON SITE FOR METASTASIS OF COLORECTAL CARCINOMA?
LIVER followed by LUNG RETROPERITONEUM OVARY PERITONEAL CAVITY RARELEY ADRENAL GLANDS
MOST COMMON COMPLICATION OF LEFT SIDED COLON CANCER?
COMPLETE OBSTRUCTION OF LARGE BOWEL (ILEUS)
MOST COMMON COMPLICATION OF RIGHT SIDED COLON CANCER?
IRON DEFIEINCY ANAEMIA > due to protracted occult blood loss
HOW MOST COMMONLY ARE PRESENTED ADVANCED RECTAL CANCER?
TENESMUS - continues urge to defecate
> can give continuous sacral pain + sometimes radiating down to perineal + thighs > as tumour invades sacrum + sacral nerve plexus
WHAT SHOULD BE THE COMPLETION OF PHYSICAL EXAMINATION IN SUSPICION OF RECTAL CANCER?
DIGITAL RECTAL EXAMINTION TO FEEL FOR MASS
ASSESS MOBILITY + POSITION
DETECT ENLARGED, EXTRARECTAL LYMPH NODES
WHY SHOULD ALL PX WITH COLORECTAL CX SHOULD HAVE PREOPERATIVE COLONOSCOPY OR AT LEAST AN AIR CONTRAST BARIUM ENEMA?
EVEN IF IT CLINICALLY OBVIOUS OF COLORECTAL TUMOUR
> radiography/ colonoscopy considered to exclude synchronous neoplasm + polyps
