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Week 10 - Malignancy Flashcards

1
Q

What are the characteristic signs of oesophageal cancer?

A
  • Dysphagia

- Weight loss

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2
Q

How do you investigate a suspected oesophageal carcinoma?

A
  • Endoscopy
  • Biopsy
  • Barium swallow
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3
Q

What is the commonest type of oesophageal carcinoma?

A

-Squamous cell carcinoma

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4
Q

Where does adenocarcinoma of the oesophagus occur?

A

-Lower thrid

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5
Q

Why is the prognosis for oesophageal cancer poor?

A
  • Many present at late stages
  • Can spread directly through oesophageal wall
  • Many patients are elderly and not suitable for resection
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6
Q

Describe the prognosis of gastric cancer

A

-Poor with less than 20% 5 year survival

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7
Q

Does gastric cancer affect females or males more?

A

-males

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8
Q

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

A

-H.pylori

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9
Q

What are the clinical features of gastric cancer?

A
  • Vague symptoms
  • Vomiting
  • Weightloss
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10
Q

How do you investigate suspected gastric cancer?

A
  • Endoscopy
  • Biopsy
  • Barium
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11
Q

Describe the macroscopic features of a gastric cancer

A

-Fungating, ulcerating, infiltrative

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12
Q

What are the two types of gastric cancer?

A
  • Intestinal

- Diffuse

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13
Q

What is characteristic histologically of diffuse gastric cancer?

A
  • Signet ring cells full of mucin

- Cells arranged singly or in small groups

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14
Q

How does gastric cancer spread?

A
  • Directly
  • Lymph nodes
  • Haematogenous to liver
  • Transcoelomic to peritoneum/ovaries
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15
Q

What are krunkenberg tumours?

A

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

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16
Q

What are the possible treatments for gastric cancer?

A
  • Surgery
  • Chemotherapy
  • Herceptin
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17
Q

What is the most common GI lymphoma?

A

-Gastric lymphoma

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18
Q

What lymph nodes involvement is associated with gastric cancer?

A

-Virchows node (left supraclavicular)

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19
Q

What are gastro-intestinal stromal tumours?

A

-Mesenchymal neoplasm which mainly occurs in the stomach

20
Q

What types of tumours occur in the large intestine?

A
  • Adenomas
  • adenocarcinomas
  • Polyps
  • anal carcinoma
21
Q

Describe the histiological features of an adenoma

A

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

22
Q

Name a genetic condition associated with adenomas

A

-Familial adenomatous polyposis

23
Q

What is the adenoma-carcinoma sequence?

A

-The stepwise development of adenocarcinomas from adenomas

24
Q

Describe features of right sided colorectal adenocarcinomas

A

-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

GI (16 decks)

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