Clinic-Esoph Tumors

Question 1

presentation with esophageal cancer

Answer 1

almost always dysphagia; sometimes weight loss; less common = chest pain, GI bleeding, SOB

Question 2

esoph cancer amost always occurs in the ____

Answer 2

elderly (avg onset 70 yrs old)

Question 3

epidemiology of SCCa

Answer 3

Aas, lower SES, smoking, EtOH, lye

Question 4

epidemiology of adenocarcinoma

Answer 4

caucasians, reflux, Barrett’s

Question 5

___ likelihood of developing adenocarcinoma from Barrett’s; ____ likelihood of dying from adeno if you get it

Answer 5

low; high

Question 6

pathophysiology of esophageal ca

Answer 6

inflammation + time = malignancy

Question 7

differential dx for sx of esophageal ca

Answer 7

esophageal strictures, extrinsic compression, viral infection of esophagus, benign growth, erosive esophagitis

Question 8

dx of esophageal cancer is made by?

Answer 8

endoscopy (sometimes preceded by barium swallow and/or followed by imaging)

Question 9

squamous cell carcinoma looks ____ on endoscopy

Answer 9

diffusely nodular

Question 10

tx of esophageal cancer

Answer 10

resection offers best hope, but high morbidity and mortality; rads/chemo palliative or pre-op to shrink tumor; can place stents

Question 11

overall, surivival from esophageal cancer is?

Answer 11

dismal

Question 12

name 6 benign esophageal tumors

Answer 12

leiomyomas, esophageal cysts, fibrovascular polyps, papillomas, granular cell tumors, lipomas (most submucosal)

Question 13

how does endoscopic ultrasound help with the diagnosis of esophageal tumors?

Answer 13

enables you to detect which layer contains a mass, and whether the mass is the same consistency as the normal tissue