Gastric tumours Flashcards
What are the benign gastric tumours
Fundic glands - no malignant potential
Hyperplastic polyps - 2% malignant potential
Adenomatous polyps - significant malignant risk
What are the different gastric cancers
Adenocarcinoma
Lymphoma
GIST
Neuroendocrine tumours
Kaposi sarcoma
What are the risk factors for gastric adenocarcinoma
Nutritional:
- Low fat and protein
- Salted meat and fish
- High nitrates
Environmental:
- Poor food preparation
- Lack of refrigeration
- Smoking
Low socioeconomic status
What are the different types of lesions according to Borrmann classification
- Polypoid or fungating
- Ulcerating lesions with raised border
- Ulcers with nfiltration of surrounding wall
- Diffusely infiltarting lesion
What are the histologic types of gastric cancer
Intestinal types
Diffuse types
What is the clinical presentation of a patient with gastric tumour
No specific symptoms
Vague epigastric discomfort and indigestion
Advance disease:
- Loss of weight
- Anorexia
- Fatigue
- Vomiting
Proximal lesions - dysphagia
Distal lesions - outlet obstruction
Early satiety
Upper GI bleeding
What is the diagnostic workup
Gastroscopy - morphological characterisation
Chest xray - determine metastatic lesions in lungs
Abdominal ultrasound - assess extent of local disease
Endoscopy ultrasound - complement CT findings
What is the treatment for gastric cancers
Dependant on stage and patient comorbidities
Tumours of the cardia and proximal stomach - total gastrectomy
Subtotal gastrectomy is sufficient for distal tumours, provided that a free margin of 5 to 6cm
Explain lymphoma of the stomach
Similar symptoms to adenocarcinoma
Bcell lymphoma is the most commonfollowed by MALT
Treated with Chemo with or without radiotherapy
Explain GIST and symptoms there of
Arises from the mesenchymal component of the gastric wall
GIST is the most common in the stomach arising from the cells of Cajal
Symptoms:
- Epigastric mass,
- Bleeding
- Epigastric pain
- Dyspepsia.
Lung most common site for metastases
