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10 GE > 4 STOMACH TUMORS > Flashcards

4 STOMACH TUMORS Flashcards

1
Q

What are the 3 benign bone tumors of the stomach?

A
  1. Epithelial 2. Mesenchymal 3. Other
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2
Q

What are the most common benign tumors of the stomach?

A

Polyps

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3
Q

Stomach Polyps could undergo malignancy in ______

A

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

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4
Q

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

A

Leiomyoma , occupies 2nd position in frequency after polyps

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5
Q

What are the 4 types of Mesenchymal benign stomach tumors?

A
  • Leiomyoma - Lipoma - Neurogenic (neurinoma aka schwannoma, aka neurilemmoma) - Vascular (glomus tumors)
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6
Q

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

A
  • Cystic - Inflammatory pseudo tumors
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7
Q

What is the Etiology of benign stomach tumors?

A

Unknown

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8
Q

What are the risk factors of benign stomach tumors?

A
  • 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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9
Q

Do patients have symptoms or no with Benign Stomach Tumors?

A

Most patients are asymptomatic for long period of time

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10
Q

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

A

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

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11
Q

What are common signs and symptoms of Benign stomach tumors?

A
  • Abdominal Pain - Nausea - Weight Loss - Acute or Chronic bleeding
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12
Q

How do you diagnose benign stomach tumor?

A
  • Upper endoscopy with multiple biopsy - CT scan - Endoscopic ultrasonography for submucosa tumors
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13
Q

What are complications of benign stomach tumors?

A
  • Malignancy - Bleeding - Ulcerations - Pyloric Canal obstruction
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14
Q

How do you treat benign stomach tumors?

A

Laparoscopic or endoscopic surgery

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15
Q

What are Malignant tumors of the stomach?

A
  1. Carcinomas (90-95% of all stomach malignant tumors) 2. Lymphomas 3. Carcinoids 4. Sarcoma
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16
Q

Carcinoma is a type of cancer that develops from _____

A

Epithelial cells

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17
Q

When do carcinomas occur?

A

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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18
Q

** Microscopically, the Gastric Carcinomas are classified to:

A
  • Early gastric carcinoma - Advanced gastric carcinoma
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19
Q

What is Early gastric carcinoma?

A

When a lesion confined to the mucosa and submucosa

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20
Q

What is Advanced gastric carcinoma?

A

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

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21
Q

What are the Macroscopic growth patterns of Gastric Carcinoma?

A
  • Exophytic - Flat or Depressed - Flat advanced (Linitis Pastica) - Excavated
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22
Q

What is Exophytic Macroscopic growth pattern?

A

With protrusion of tumor into the lumen

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23
Q

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

A

In which there is no obvious tumor mass within the Mucosa

24
Q

Flat advanced gastric carcinoma is also known as _____

A

Linitis Plastica

25
Q

What is Excavated macroscopic growth patterns of Gastric Carcinoma ?

A

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

26
Q

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

A
  • Intestinal Type Adenocarcinoma - Diffuse Stomach Carcinoma
27
Q

What is Intestinal type Adenocarcinoma composed of?

A

Neoplastic intestinal glands

28
Q

What is Diffuse Gastric Carcinoma composed of?

A

Gastric - type mucous cells

29
Q

What type of tumor is Intestinal type Adenocarcinoma ?

A

Exophytic (Projectile) *

30
Q

What type of tumor is Diffuse Gastric Carcinoma?

A

A flat tumor

31
Q

What is the latent period of Intestinal Type Adenocarcinoma ?

A

Relatively LONG latent period

32
Q

What is the latent period of Diffuse Gastric Carcinoma?

A

Has SHORT latent period *

33
Q

What are the risk factors of Diffuse Gastric Carcinoma?

A

UNDEFINED

34
Q

What is the association that is with Intestinal type Adenocarcinoma ?

A

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

35
Q

What is the association that is Diffuse Gastric Carcinoma ?

A

THere is NO association with chronic gastritis and Helicobacter Pylori infection

36
Q

Diffuse stomach carcinoma is a typical example of _____

A

Scirrhous cancer (aka scirr) **

37
Q

What is Diffuse stomach carcinoma also known as?

A

Leather bottle stomach and Linitis Plastica

38
Q

What represents 5% of all gastric malignancies?

A

Gastric Lymphomas

39
Q

Gastric carcinoma is generally _____

A

Asymptomatic until late in its course

40
Q

Stomach cancer arises from any part of the stomach, but _____

A

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

41
Q

What are 3 early clinical manifestations of Malignant stomach tumors?

A
  • Heartburn - Loss of appetite, especially for meet - Abdominal discomfort or irritability
42
Q

What is a unique sign of malignant stomach tumor?

A

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

43
Q

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

A

Tripe palms (aka ACANTHOSIS PALMARIS) **

44
Q

What is Tripe Palms (aka ACANTHOSIS palmaris)?

A

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

45
Q

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

A

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

46
Q

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

A
  1. Weakness and fatigue 2. Bloating of the stomach, usually after meal
47
Q

What are late clinical manifestations of Malignant tumors?

A
  1. Upper abdominal pain 2. Weight loss 3. Nausea and vomiting 4. Diarrhea or constipation
48
Q

What are very severe late clinical manifestations of malignant tumors?

A
  1. Bleeding (hematemesis, melena) 2. Signs of anemia 3. Dysphagia
49
Q

How does Carcinoma generally metastasize?

A

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

50
Q

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

A

Virchow’s node

51
Q

Where is Virchow’s node?

A

Left supraclavicular fossa

52
Q

Mets of malignant stomach tumors can send to ____

A

The liver via the blood

53
Q

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

A

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

54
Q

Where can METS of stomach tumors also send Mets?

A

To the pancreas and lungs

55
Q

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

A

Krukenberg Tumors

56
Q

What is treatment of Malignant stomach tumors?

A
  • Surgery - Chemotherapy - Radiation Therapy

10 GE (6 decks)

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