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Flashcards in Week 10 - Malignancy Deck (45):
1

What are the characteristic signs of oesophageal cancer?

-Dysphagia
-Weight loss

2

How do you investigate a suspected oesophageal carcinoma?

-Endoscopy
-Biopsy
-Barium swallow

3

What is the commonest type of oesophageal carcinoma?

-Squamous cell carcinoma

4

Where does adenocarcinoma of the oesophagus occur?

-Lower thrid

5

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

6

Describe the prognosis of gastric cancer

-Poor with less than 20% 5 year survival

7

Does gastric cancer affect females or males more?

-males

8

What bacteria is associated with gastric cancer and strongly with gastric lymphoma?

-H.pylori

9

What are the clinical features of gastric cancer?

-Vague symptoms
-Vomiting
-Weightloss

10

How do you investigate suspected gastric cancer?

-Endoscopy
-Biopsy
-Barium

11

Describe the macroscopic features of a gastric cancer

-Fungating, ulcerating, infiltrative

12

What are the two types of gastric cancer?

-Intestinal
-Diffuse

13

What is characteristic histologically of diffuse gastric cancer?

-Signet ring cells full of mucin
-Cells arranged singly or in small groups

14

How does gastric cancer spread?

-Directly
-Lymph nodes
-Haematogenous to liver
-Transcoelomic to peritoneum/ovaries

15

What are krunkenberg tumours?

-Tumours of the overy which have metastasised from a primary site

16

What are the possible treatments for gastric cancer?

-Surgery
-Chemotherapy
-Herceptin

17

What is the most common GI lymphoma?

-Gastric lymphoma

18

What lymph nodes involvement is associated with gastric cancer?

-Virchows node (left supraclavicular)

19

What are gastro-intestinal stromal tumours?

-Mesenchymal neoplasm which mainly occurs in the stomach

20

What types of tumours occur in the large intestine?

-Adenomas
-adenocarcinomas
-Polyps
-anal carcinoma

21

Describe the histiological features of an adenoma

-Can be sessile or pedunculated with a variable degree of dysplasia

22

Name a genetic condition associated with adenomas

-Familial adenomatous polyposis

23

What is the adenoma-carcinoma sequence?

-The stepwise development of adenocarcinomas from adenomas

24

Describe features of right sided colorectal adenocarcinomas

-Fungating and unlikely to cause obstruction

25

Describe features of left sided colorectal adenocarcinomas

-Stenotic and likely to cause obstruction

26

Where do colorectal adenocarcinomas commonly occur?

-Distally in rectum and sigmoid

27

What is an applecore stricture characteristic off?

-Colorectal adenocarcinoma

28

How do colorectal adenocarcinomas spread?

-Directly through the bowel wall to adjacent organs
-Lympatics
-Portal system to liver

29

Describe dukes staging

-A-> in the wall
-B-> through the wall
-C-> involves lymph nodes

30

At what age do adenocarcinomas usually present?

-60-70

31

Describe some risk factors for colorectal adenocarciomas

-Slow transit time
-Low residue diet
-High fat intake
-Genetic predisposition

32

What metastases are common in advanced colorectal carcinoma?

-Liver

33

Name 3 other large intestinal tumours besides adencarcinoma

-Carcinoid tumour
-Lymphoma
-Stromal tumour (lyomyoma)

34

Why is the prognosis of pancreatic carcinoma so poor?

-Very difficult to diagnose until very late stage
-Early symptoms are vague

35

What are the presenting features of pancreatic tumour?

-Weight loss
-Jaundice
-Trousseau's sign

36

Where do most pancreatic carcinomas occur?

-In the head

37

How does a pancreatic carcinoma appear on inspection?

-Pale firm mass until cut
-Inside is necrotic, haemorrhagic

38

In what cells do pancreatic tumours most often arise?

-Ductal

39

Why can pancreatic cancer give a silvery stool?

-Malnutrition and lack of bile

40

What types of islet cell tumours are there?

-Insulinoma
-Glucagonoma
-VIPoma
-Gastrinoma

41

Which clinical presentation is caused by a gastrinoma?

-Zollinger-ellison syndrome

42

Name 2 benign tumours of the liver

-Hepatic adenoma
-Haemangioma

43

Name 2 malignant tumours of the liver

-Hepatocellular carcinoma
-Cholangiocarcinoma

44

What is the most common GI cancer?

-Colorectal

45

What are the two types of oesophageal cancer?

-Squamous cell
-Adenocarcinoma