Detection and Diagnosis of Malignancy Flashcards
4 signs that a primary tumor is present?
- Sensation of a mass
- Invasion of adjacent structures
- Obstruction
- Compression
4 signs that a primary tumor is present?
- Sensation of a mass
- Invasion of adjacent structures
- Obstruction
- Compression
2 cancers that may be palpable or cause a sensation of a mass?
Breast cancer
Soft-tissue sarcomas
What type of invasion from a primary tumor is more concerning for malignancy?
Skin invasion
ex. breast cancer
There are many options for tumors to cause obstruction. What is an example of a tumor that can cause airway obstruction?
Lung carcinoma growing endobronchially
Signs that a tumor is causing airway obstruction?
Stridor
Downstream lung tissue is collapsed
What is Superior Vena Cava Syndrome?
When a primary tumor is obstructing the superior vena cava from draining into the heart
Symptoms of Superior Vena Cava Syndrome?
Venous distention of neck and chest wall
Facial and upper arm edema
Venous distention of neck and chest wall, as well as facial and upper arm edema can suggest what type of tumor obstruction?
Superior Vena Cava Syndrome
What physical sign will be positive with Superior Vena Cava Syndrome?
Pemberton’s sign
Describe Pemberton’s sign
Exaggeration of Superior Vena Cava Syndrome findings when the arms are raised above the head
Exaggeration of SVC syndrome when the arms are raised above the head is what sign?
Pemberton’s sign
What is the most common type of compression from a primary tumor?
Spinal cord compression
Another sign of a primary tumor may be abnormal _____
Bleeding!
Post-menopausal women “menstruating again” may suggest?
Uterine/endometrial cancer
Blood should never be present in bodily fluids. Besides that symptom, what is another sign of hemorrhage?
Pain!
- often caused by ABRUPT hemorrhage
Chronic bleeding can manifest as?
Iron deficient anemia
Tumor cells can also irritate?
Peritoneum and pleural space
If an ovarian carcinoma irritates the peritoneum, what is an example of how that will present?
Ovarian carcinoma –> ASCITES
If a tumor irritates the pleural space, what will that cause to form?
Malignant pleural effusion
What measures can provide both therapeutic and diagnostic value to effusions?
Thoracentesis and Paracentesis
Low protein and low cell count effusion
Transudative
High protein and high cell count effusion
Exudative
History taking, Physical exam and Lab testing can all suggest different aspects of primary tumor presentation. What can catch all of them?
Radiography
Cancer staging pneumonic
TNM
- Tumor size
- Nodal involvement
- Metastasis extent
4 types of metastatic spread?
- Lymphatic
- Hematogenous
- Transcoelomic
- Canalicular
Transcoelomic spread?
Invades the serosa
Canalicular spread?
Travels along pre-existing duct/lumen
What types of cancers spread through the lymphatics usually?
Carcinomas
Carcinomas usually spread via?
Lymphatics
What types of cancers spread through hematogenous (blood)?
Sarcomas and advanced carcinomas
Sarcomas usually spread via?
Hematogenous spread (blood)
Advanced carcinomas can also spread via?
Hematogenous spread (blood)
On physical exam to check for metastasis you should check?
Lymph nodes
With lung carcinoma, checking hilar and mediastinal lymph nodes requires?
Radiography
Describe how to know what lymph nodes must be dissected from metastatic cancer spread?
- Inject radiotracer dye into tumor
- Dye will spread to sentinel node first
- Take out the involves nodes with the dye in them
Common metastatic cancer symptoms?
Fatigue and weight loss
Bone/back pain
Neurological symptoms
Compression/obstruction
What is a Sister Mary Joseph Nodule?
Umbilical metastasis from ovarian carcinoma
What causes a Sister Mary Joseph Nodule?
Ovarian carcinoma
Umbilical metastasis is considered a?
Sister Mary Joseph Nodule
What is Virchow’s node?
Left supraclavicular lymphadenopathy from ANY thoracic or abdominal carcinoma
What causes Virchow’s node?
ANY thoracic or abdominal carcinoma
Where is Virchow’s node?
Left supraclavicular lymphadenopathy
Why is Virchow’s node where it is?
It is near the site of where the thoracic duct (that drains 3/4 of the body’s lymph) drains into the subclavian vein
Recurrences of cancer are typically _____
Metastatic
