GI Malignancy

Question 1

What is the histology of the following:

1. tumours of the upper 2/3 of the oesophagus
2. tumours of the lower 1/2 of the oesophagus

Answer 1

1. squamous cell carcinoma

2. adenocarcinoma

Question 2

Name risk factors for squamous cell carcinoma of the oesophagus (6)

Answer 2

1. tobacco smoking
2. high alcohol intake
3. corrosive strictures
4. coeliac disease
5. Achalasia
6. breast cancer treated with radiotherapy

Question 3

Name risk factors for adenocarcinoma of the oesophagus (6)

Answer 3

1. longstanding GORD
2. Barret’s oesophagus
3. smoking
4. obesity
5. breast cancer treated with radiotherapy
6. older age

Question 4

1. What is the main presentation of oesophageal cancer?

2. Name some other symptoms which could indicate oesophageal cancer

Answer 4

1. progressive dyspgagia ± odynophagia
2. weight loss/anorexia
   cough and aspiration
   hoarse voice

Question 5

What are the main investigations for oesophageal cancer?

Answer 5

1. OGD
2. barium swallow (particularly useful if OGD not tolerated)
3. CT thorax and abdomen

Question 6

1. What are the 2 main types of gastric cancer?
2. Which type is associated with H pylori infection?
3. Which type is histologically an adenocarcinoma?
4. Which type offers the worse prognosis?

Answer 6

1. Intestinal and Diffuse
2. Intestinal
3. Intestinal
4. diffuse

Question 7

1. describe symptoms of gastric cancer

2. Which sign is important to look for

Answer 7

1. epigastric pain; vomiting, dysphagia, weight loss, early satiety, anaemia
2. virchow’s node

Question 8

Name 2 predisposing factors for small bowel maliganacy

Answer 8

1. Crohn’s disease

2. Coeliac Disease