Week 10 GI malignancy

Question 1

what are the clinical features of oesophageal carcinoma and what investigations are commonly done?

Answer 1

dysphagia- progressively worse
weight loss- cancer and dont want to eat as difficult
endoscopy to take a biopsy
barium used to be used

Question 2

what are types of oesophageal carcinoma?

Answer 2

squamous cell carcinoma- commonest type, can occur at any level down to stomach
adenocarcinoma- uncommon, lower third, associated with barretts oesophagus

Question 3

describe the aetiology/ pathogenesis of squamous cell carcinoma/ adenocarcinoma

Answer 3

squamous cell carcinoma:

• some relation to HPV, vitamin deficiency- A, riboflavin
• presumed progression through dysplasia

adenocarcinoma:

• metaplastic (change from one differentiated type to another) epithelium of barretts- becomes glandular mucosa due to reflux
• progresses through dysplasia

Question 4

describe the prognosis of oesophageal carcinoma

Answer 4

advanced disease at presentation usually
direct spread through oesophageal wall- only 40% resectable
many pts have tube passed through tumour to facilitate swallowing
5% five year surviva

Question 5

describe the epidemiology of Oesophagus- how common in UK, Males:females, how common worldwide

Answer 5

2% malignancy in UK
Males > females
low incidence in USA, high incidence around caspian sea, china

Question 9

stomach

Answer 9

d

Question 10

large intestine

Answer 10

d

Question 11

pancreas

Answer 11

d

Question 12

liver

Answer 12

d