Oesophageal carcinoma Flashcards
What are RFs for oesophageal carcinoma?
Diet alcohol XS Smoking achalasia reflux +/- Barrett's obesity hot drinks nitrosamine exposiure
What % occur in the upper part of the oesophagus?
20
What % occur in the middle part of the oesophagus?
50
what % occur in the lower part of the oesophagus?
30
What is the histological pathology of oesophageal carcinoma?
proximally - squamous
distally - squamous
How does oesophageal ca present? (including upper third)
Dysphagia
WL
Retrosternal chest pain
Upper third - hoarseness, cough
What are DDs of oesophageal ca?
causes of dysphagia
What tests would u do for oesophageal ca?
oesophagoscopy w biopsy
EUS, CT/MRI for staging
What are the possible treatments for oesophageal ca?
radical curative oesophagectomy
pre-op chemo (cisplatin + fluorouracil) for localised disease to improve survival
What is involved in palliative rx of oesophageal ca?
restore swallowing w:
chemo/radiotherapy
stenting
laser
What is the most common histopathology and anatomy of carcinoma of the stomach?
adenocarcinoma at the gastro-oesophageal junction
What are RFs for carcinoma of the stomach?
pernicious anaemia blood group A H.pylori atrophic gastritis adenomatous polyps smoking diet: high nitrate, salt, pickling, low bit C) Nitrosamine exposure
How does carcinoma of the stomach present?
often non-specific dyspepsia WL vomiting dysphagia anaemia Most present w locally advanced or metastatic disease
What signs of carcinoma of the stomach suggest incurable disease?E
epigastric mass hepatomegaly jaundice ascites Virchows node + Trousers sign acanthuses nigricans
What tests would u do for carcinoma of the stomach?
gastroscopy + multiple ulcer edge biopsies
endoscopic US
CT/MRI staging
staging laparoscopy
