4 STOMACH TUMORS Flashcards by Clint Eastwood

What are the 3 benign bone tumors of the stomach?

Epithelial 2. Mesenchymal 3. Other

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What are the most common benign tumors of the stomach?

Polyps

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Stomach Polyps could undergo malignancy in ______

4-30% of cases (hyperplastic polyps and Adenomas)

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What is the category of benign tumors under Mesenchymal derived stomach tumors?

Leiomyoma , occupies 2nd position in frequency after polyps

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What are the 4 types of Mesenchymal benign stomach tumors?

Leiomyoma - Lipoma - Neurogenic (neurinoma aka schwannoma, aka neurilemmoma) - Vascular (glomus tumors)

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What are the subcategories under “Other” section of benign stomach tumors?

Cystic - Inflammatory pseudo tumors

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What is the Etiology of benign stomach tumors?

Unknown

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What are the risk factors of benign stomach tumors?

Chronic H Pylori infection of the stomach - Autoimmune gastritis - Radiation Gastritis - Genetic abnormalities - Long term medication use antacids (proton pump inhibitors PPI)

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Do patients have symptoms or no with Benign Stomach Tumors?

Most patients are asymptomatic for long period of time

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When symptoms are present with benign stomach tumors, what do they depend on?

Their severity and clinical outcomes depend on the tumor size, location, and complications (bleeding, ulceration)

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What are common signs and symptoms of Benign stomach tumors?

Abdominal Pain - Nausea - Weight Loss - Acute or Chronic bleeding

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How do you diagnose benign stomach tumor?

Upper endoscopy with multiple biopsy - CT scan - Endoscopic ultrasonography for submucosa tumors

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What are complications of benign stomach tumors?

Malignancy - Bleeding - Ulcerations - Pyloric Canal obstruction

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How do you treat benign stomach tumors?

Laparoscopic or endoscopic surgery

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What are Malignant tumors of the stomach?

Carcinomas (90-95% of all stomach malignant tumors) 2. Lymphomas 3. Carcinoids 4. Sarcoma

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Carcinoma is a type of cancer that develops from _____

Epithelial cells

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When do carcinomas occur?

Carcinomas occur when the DNA of a cell is damaged or altered and the cell begins to grow uncontrollably and become malignant

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** Microscopically, the Gastric Carcinomas are classified to:

Early gastric carcinoma - Advanced gastric carcinoma

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What is Early gastric carcinoma?

When a lesion confined to the mucosa and submucosa

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What is Advanced gastric carcinoma?

When a neoplasm has extended below the submucosa into the muscular wall

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What are the Macroscopic growth patterns of Gastric Carcinoma?

Exophytic - Flat or Depressed - Flat advanced (Linitis Pastica) - Excavated

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What is Exophytic Macroscopic growth pattern?

With protrusion of tumor into the lumen

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What is Flat or Depressed Macroscopic growth patterns of Gastric Carcinoma?

In which there is no obvious tumor mass within the Mucosa

Flat advanced gastric carcinoma is also known as _____

Linitis Plastica

What is Excavated macroscopic growth patterns of Gastric Carcinoma ?

Whereby the shallow or deeply erosive crater is present in the wall of the stomach

What are the 2 most most common carcinomas that are malignant?

- Intestinal Type Adenocarcinoma - Diffuse Stomach Carcinoma

What is Intestinal type Adenocarcinoma composed of?

Neoplastic intestinal glands

What is Diffuse Gastric Carcinoma composed of?

Gastric - type mucous cells

What type of tumor is Intestinal type Adenocarcinoma ?

Exophytic (Projectile) \*

What type of tumor is Diffuse Gastric Carcinoma?

A flat tumor

What is the latent period of Intestinal Type Adenocarcinoma ?

Relatively LONG latent period

What is the latent period of Diffuse Gastric Carcinoma?

Has SHORT latent period \*

What are the risk factors of Diffuse Gastric Carcinoma?

UNDEFINED

What is the association that is with Intestinal type Adenocarcinoma ?

Close association with chronic gastritis (due to intestinal metaplasia) and Helicobacter Pylori infection

What is the association that is Diffuse Gastric Carcinoma ?

THere is NO association with chronic gastritis and Helicobacter Pylori infection

Diffuse stomach carcinoma is a typical example of \_\_\_\_\_

Scirrhous cancer (aka scirr) \*\*

What is Diffuse stomach carcinoma also known as?

Leather bottle stomach and Linitis Plastica

What represents 5% of all gastric malignancies?

Gastric Lymphomas

Gastric carcinoma is generally \_\_\_\_\_

Asymptomatic until late in its course

Stomach cancer arises from any part of the stomach, but \_\_\_\_\_

A favored location is the lesser curvature of the antrum-pyloric region

What are 3 early clinical manifestations of Malignant stomach tumors?

- Heartburn - Loss of appetite, especially for meet - Abdominal discomfort or irritability

What is a unique sign of malignant stomach tumor?

Darkness of the skin, frequently locating in the axils and groin, known as ACANTHOSIS NIGRICANS\*\*

What do you see with the extremities with Stomach malignant tumors?

Tripe palms (aka ACANTHOSIS PALMARIS) \*\*

What is Tripe Palms (aka ACANTHOSIS palmaris)?

A skin condition in which the skin of the palm becomes thick and velvety hyperpigmentation with pronounced folds in the lines of the hand \*\* In over 40% of patients, tripe palms are the 1st sign of undiagnosed cancer

What is visible on chest and back in early manifestations of Malignant stomach tumors?

Sudden eruption of multiple Seborrheic Keratosis (Leser-Trelat sign)

What are 2 advanced clinical manifestation IN ADDITION to early symptoms and signs of Malignant tumors?

1. Weakness and fatigue 2. Bloating of the stomach, usually after meal

What are late clinical manifestations of Malignant tumors?

1. Upper abdominal pain 2. Weight loss 3. Nausea and vomiting 4. Diarrhea or constipation

What are very severe late clinical manifestations of malignant tumors?

1. Bleeding (hematemesis, melena) 2. Signs of anemia 3. Dysphagia

How does Carcinoma generally metastasize?

Stomach carcinomas give metastasis predominantly through lymphatic system, primarily to regional lymphatic nodes

Stomach carcinomas give met to a lymphatic node in the left supraclavicular fossa known as \_\_\_\_

Virchow’s node

Where is Virchow’s node?

Left supraclavicular fossa

Mets of malignant stomach tumors can send to \_\_\_\_

The liver via the blood

What is blood in the liver associated with Mets with stomach tumors, associated with?

It is associated with predominate venous blood flow from GI tract organs to portal vein

Where can METS of stomach tumors also send Mets?

To the pancreas and lungs

In females, the stomach carcinoma could sometimes metastasize through the abdominal cavity, giving rise to development of secondary ovarian cancer called \_\_\_\_\_\_\_

Krukenberg Tumors

What is treatment of Malignant stomach tumors?

- Surgery - Chemotherapy - Radiation Therapy