Flashcards in Week 10 - Malignancy Deck (45):
What are the characteristic signs of oesophageal cancer?
How do you investigate a suspected oesophageal carcinoma?
What is the commonest type of oesophageal carcinoma?
-Squamous cell carcinoma
Where does adenocarcinoma of the oesophagus occur?
Why is the prognosis for oesophageal cancer poor?
-Many present at late stages
-Can spread directly through oesophageal wall
-Many patients are elderly and not suitable for resection
Describe the prognosis of gastric cancer
-Poor with less than 20% 5 year survival
Does gastric cancer affect females or males more?
What bacteria is associated with gastric cancer and strongly with gastric lymphoma?
What are the clinical features of gastric cancer?
How do you investigate suspected gastric cancer?
Describe the macroscopic features of a gastric cancer
-Fungating, ulcerating, infiltrative
What are the two types of gastric cancer?
What is characteristic histologically of diffuse gastric cancer?
-Signet ring cells full of mucin
-Cells arranged singly or in small groups
How does gastric cancer spread?
-Haematogenous to liver
-Transcoelomic to peritoneum/ovaries
What are krunkenberg tumours?
-Tumours of the overy which have metastasised from a primary site
What are the possible treatments for gastric cancer?
What is the most common GI lymphoma?
What lymph nodes involvement is associated with gastric cancer?
-Virchows node (left supraclavicular)
What are gastro-intestinal stromal tumours?
-Mesenchymal neoplasm which mainly occurs in the stomach
What types of tumours occur in the large intestine?
Describe the histiological features of an adenoma
-Can be sessile or pedunculated with a variable degree of dysplasia
Name a genetic condition associated with adenomas
-Familial adenomatous polyposis
What is the adenoma-carcinoma sequence?
-The stepwise development of adenocarcinomas from adenomas
Describe features of right sided colorectal adenocarcinomas
-Fungating and unlikely to cause obstruction
Describe features of left sided colorectal adenocarcinomas
-Stenotic and likely to cause obstruction
Where do colorectal adenocarcinomas commonly occur?
-Distally in rectum and sigmoid
What is an applecore stricture characteristic off?
How do colorectal adenocarcinomas spread?
-Directly through the bowel wall to adjacent organs
-Portal system to liver
Describe dukes staging
-A-> in the wall
-B-> through the wall
-C-> involves lymph nodes
At what age do adenocarcinomas usually present?
Describe some risk factors for colorectal adenocarciomas
-Slow transit time
-Low residue diet
-High fat intake
What metastases are common in advanced colorectal carcinoma?
Name 3 other large intestinal tumours besides adencarcinoma
-Stromal tumour (lyomyoma)
Why is the prognosis of pancreatic carcinoma so poor?
-Very difficult to diagnose until very late stage
-Early symptoms are vague
What are the presenting features of pancreatic tumour?
Where do most pancreatic carcinomas occur?
-In the head
How does a pancreatic carcinoma appear on inspection?
-Pale firm mass until cut
-Inside is necrotic, haemorrhagic
In what cells do pancreatic tumours most often arise?
Why can pancreatic cancer give a silvery stool?
-Malnutrition and lack of bile
What types of islet cell tumours are there?
Which clinical presentation is caused by a gastrinoma?
Name 2 benign tumours of the liver
Name 2 malignant tumours of the liver
What is the most common GI cancer?