Neoplasia

Question 1

Which cancer is the third most common for cases and death?

Answer 1

Adenocarcinoma of the colon and rectum.

men (following prostate and lung or bronchus cancer) women (following breast and lung or bronchus cancer)

Question 2

how much higher is the risk for colorectal cancer for someone with a first-degree relative of a patient diagnosed with colorectal cancer before the age of 50 years

Answer 2

twice as likely as an individual in the general population to develop the cancer.

Question 3

which type of gene is APC?

Answer 3

Tumor suppressor

Question 4

In which gene does the earliest mutations in the adenoma-carcinoma sequence occur?

Answer 4

APC gene

Question 5

which gene mutation is responsible for FAP disease?

Answer 5

APC

Question 6

how many cases of FAP are de novo mutation?

Answer 6

30%

Question 7

How FAP is characterized?

what ages?

Answer 7

Typically more than 100 adenomatous polyps present in the colon and rectum.
These polyps often number in the thousands and are almost always manifested by the late second or early third decade of life.

Question 8

age of survival for non operated patient with FAP?

Answer 8

Fifth decade of life

Question 9

What is the Gardner syndrome?

Answer 9

type of FAP
coexpression of profuse colonic adenomatous polyps along with osteomas of the mandible and skull, desmoid tumors of the mesentery, and periampullary neoplasms.

Question 10

which tumor suppressor gene is the most frequently mutated gene in human neoplasia?
How many colorectal cancers have this mutation?

Answer 10

P53.
75% of colorectal cancers.
occur rather late in the adenoma-carcinoma sequence

Question 11

P53 MOA?

Answer 11

Inducing apoptosis in response to cellular
damage or…
By causing G1 cell cycle arrest, allowing DNA repair mechanisms to occur.

Question 12

which gene is responsible for HNPCC?

Answer 12

MMR

Question 13

HNPCC - full term and another name

Answer 13

hereditary nonpolyposis colorectal cancer.

Lynch syndrome

Question 14

which type of polyp carries a higher risk?

villous adenoma or tubular adenoma?

Answer 14

villous adenomas

Question 15

What is the percentage of patients with FAP that will develop colorectal cancer in the absence of surgical intervention?

Answer 15

almost 100%

Question 16

what is the colorectal carcinogenesis sequence of invasion?

Answer 16

invasion of the muscularis mucosae,

pericolic tissue, and lymph nodes and, finally, distant metastasis

Question 17

what are the 3 types of colonic polyps?

descirbe each histology

Answer 17

Tubular adenoma (branched tubular glands)
Villous adenoma (long finger-like projections of the surface epithelium)
Tubulovillous adenoma (elements of both).

Question 18

how many colon polyps are tubular, villous and tubulovillous adenoma?

Answer 18

tubular adenoma - 65% to 80%
tubulovillous - 10% to 25%
villous adenomas - 5% to 10% are

Question 19

the macroscopic look of a tubular adenoma is more often… and willous adenoma is more often…

Answer 19

Tubular - pedunculated;

villous - sessile

Question 20

which colonic polyp has more sever atypia and dysplasia?

Answer 20

villous adenomas.

there is generally less atypia in tubular adenomas

Question 21

what is the chance for carcinoma depending on the size of a colonic polyp?

Answer 21

adenomatous < 1 cm in diameter, - less than 5%

villous >2cm - 50%

Question 22

which type of polyps cannot be removed with colonoscopy? why?

Answer 22

Sessile lesions that are large or have a central
depression or cannot be “lifted” with saline may be perforation risks and should be surgically excised by segmental colectomy for complete removal and lymph node examination.

Question 23

what is the description of an invasive colonic carcinoma?

Answer 23

When malignant cells have extended through the muscularis mucosae of the polyp