16) Common GI Malignancies Flashcards
Which organs are common GI malignancies found in?
Oesophagus Stomach Large intestine Pancreas Liver
What percentage of malignancies in UK are oesophageal carcinoma?
2%
How does oesophageal carcinoma present?
Dysphagia (worsening as tumour grows)
Weight loss
What investigations may be used for suspected oesophageal carcinoma?
Endoscopy, biopsy, barium
What is the most common type of oesophageal carcinoma and where does it occur?
Squamous cell carcinoma
May occur at any level
What is the second most common type of oesophageal carcinoma and where does it occur?
Adenocarcinoma
Lower third, associated with Barrett’s oesophagus
How does an oesophageal adenocarcinoma progress?
Arises in metaplastic epithelium of Barrett’s oesophagus and progresses through dysplasia
Why is the prognosis of oesophageal carcinoma so bad?
Advanced disease at presentation, as usually spread through oesophageal wall
Only 40% resectable
What is the five year survival of oesophageal carcinoma?
5%
What treatment can be given in oesophageal cancer to relieve symptoms?
Local radiotherapy to shrink tumour
Tube passed through tumour to facilitate swallowing
What things is gastric cancer associated with?
Blood group A
Gastritis
How does gastric cancer present?
Vague symptoms: epigastric pain, vomiting, weight loss
What investigations may be done if gastric cancer is suspected?
Endoscopy, biopsy, barium
What are some macroscopic features of gastric cancer?
Fungating
Ulcerating
Infiltrative (linitis plastica)
What two types of microscopic gastric cancer can be seen?
Intestinal
Diffuse
What are the features of intestinal gastric cancer?
Variable degree of gland formation
What are the features of diffuse gastric cancer?
Single cell or small groups
Signet ring cells
Why are the nuclei of signet ring cells at the peripheries?
Signet ring cell is full of mucins so pushes nucleus
Describe early gastric cancer:
Confined to mucosa/submucosa
Good prognosis
Describe advanced gastric cancer:
Further spread, 10% five year survival