Malignancy Flashcards
what are the 3 types of colorectal cancer
- sporadic
- HNPCC (Lynch syndrome)
- FAP
what is the most common form of inherited colon cancer
HNPCC - autosomal dominant
- causes pt to develop poorly differentiated and highly aggressive cacners of the proximal colon
what other type of cancer is HNPCC associated with
endometrial cancer
what criteria can be used to diagnose colorectal cancer
Amsterdam
* at least 3 family members with colon cancer
* the cases span at least two generations
* at least one case diagnosed before the age of 50 years
what is FAP
autosomal dominant condition that leads to 100s of polyps by 30-40 years and pt inevitably develops carcinoma
- due to mutation in TSG called APC on Chr 5
- genetic testing from DNA analysis of WBC
what is the management of FAP
total proctocolectomy with ileal pouch anal anastomosis in 20s
what other tumour are pt w FAP at risk fo
duodenal
what is the most prevalent type of gastric cancer
gastric adenocarcinoma from glandular epithelium of stomach lining
what investigation is used to diagnose gastric cancer and what sign is present
OGD with biopsy
- signet ring cells which contain large vacuole of mucin which displaces nucleus to one side
- high number ~ worse prognosis
what is the most common cause of HCC in the world
chronic hep B
what is the most common cause of HCC in europe
chronic hep C
what are risk factors developing HCC
liver cirrhosis! can be secondary to Hep B&C, alcohol, HH, PBC
- alpha-1 antitrypsin
- glycogen storage disease e.g. mcardle’s, von gierke
- drugs e.g. COCP
what is the tumour marker for HCC
alpha-fetoprotein
what is the 1st line imaging investigation for HCC
liver USS
what imaging is used to further assess and stage HCC
CT and MRI
what is the prognosis of HCC
very poor unless diagnosed early
what are treatment options for HCC
- surgery may be possible in early disease
- resection if tumour is isolated
- liver transplant when tumour only in liver
- radiofrequency ablation
- TACE
- RT
what are type of carcinoma are most cholangiocarcinomas
adenocarcinomas
what is the most common site of cholangiocarcinoma
perihilar region where right and left hepatic ducts join to become CHD
what condition is cholangiocarcinoma assocaited with
PSC
what is the key presenting feature of cholangiocarcinoma
obstructive jaundice
- pale stools
- dar urine
- generalised itching
what is a tumour marker for cholangiocarcinoma
CA19-9
