8. Upper GI Malignancy Flashcards
In general terms, what can cause dysphagia?
Extraluminal
Intraluminal
Luminal - progressive dysphagia
What are the ALARM symptoms for dysphagia?
Anaemia Loss of weight - unintentional Anorexia Recent onset of progressive symptoms Masses/Malaena
What are more specific causes of dysphagia?
Benign - strictures, foreign bodies, nerves
Malignant - (type of carcinoma links to its epithelium) stratified squamous (squamous cell carcinoma), columnar epithelium (adenocarcinoma)
What are most oesophageal cancers?
Squamous cell carcinoma, lower 1/3 can develop adenocarcinoma
What are the risk factors for oesophageal cancer?
Barrett’s
Smoking
What investigations can you do to see oesophageal cancer?
Endoscopy
Barium swallow
What is the prognosis of oesophageal cancer?
5% in 5 years
What are some causes of epigastric pain?
Benign - gastritis, peptic ulcers, pancreatitis
Gastric cancer
What are the red flags in epigastric pain?
Malaena
Haematemesis
What are some causes of haematemesis?
Gastric cancer
Varices, ulcers, Mallory-Weiss
What are gastric cancers usually?
Adenocarcinoma in cardia or antrum
What are the risk factors for gastric cancer?
Smoking High salt diet Family history H. Pylori Male Increased age
What investigation can be done to identify gastric cancer?
Endoscopy
What is the prognosis of gastric cancer?
10% 5 year survival rate
Up to 50% if surgery
What are some rarer gastric cancers?
Gastric lymphoma
Gastrointestinal stromal tumours (GISTs) - sarcoma
What are the red flags with jaundice?
Unintentional weight loss
Hepatomegaly (irregular border)
Ascites
Painless
What are possible malignancies with jaundice?
Hepatocellular carcinoma - links to underlying condition (chronic inflammation)
Metastasis in liver due to portal circulation - breast, colon, lung, skin, ovaries, etc.
What are the 3 ways metastasis can travel?
Haematogenous
Lymph
Transcoelomic - through body cavity
What are most pancreatic cancers?
Exocrine - ductal adenocarcinoma
What is a rare form of pancreatic cancer?
Neuroendocrine
What is the presentation of ductal adenocarcinoma?
Head of pancreas - jaundice
Tail of pancreas - malabsorption
What are some risk factors for pancreatic cancer?
Family history Smoking Male Increased age Chronic pancreatitis
What is the prognosis for pancreatic cancer?
Extremely poor - months
What are some rarer cancers that can cause jaundice?
Cholangiocarcinoma
