Oesophageal tumours - pathology Flashcards
How common are benign oesophageal tumours?
Uncommon- they make up 5% of neoplasms of the oesophagus.
What are the most common benign oesophageal tumours?
Leiomyoma- smooth muscle tumours
What is another type of benign oesophageal tumour?
Squamous papilloma
This is rare and asymptomatic
It is related to HPV
What are the 2 main types of malignant oesophageal tumour?
Squamous cell carcinoma and adenocarcinoma
What do most adenocarcinomas arise from?
Barrett’s oesophagus
What are the main risk factors for squamous cell carcinoma?
Tobacco
Alcohol
Nitrosamine in picked/mouldy food
Vitamin deficiencies (A) and zinc deficiency
Repeated thermal injuries due to hot beverages
HPV infection
Is squamous cell carcinoma more common in males or females?
Males
What do squamous cell carcinomas arise from?
Squamous epithelium
They may be preceded by dysplastic changes
Where in the oesophagus are adenocarcinomas most common?
In the lower 1/3 of the oesophagus
What are the most common predisposing factors for adenocarcinomas?
GORD and Barrett’s oesophagus
Describe the classic pathogenesis of adenocarcinoma in the oesophagus
Genetic factors, reflux disease, others
- -> Chronic reflux oesophagitis
- -> Barrett’s oesophagus
- -> low grade dysplasia
- -> high grade dysplasia
- -> adenocarcinoma
How does a carcinoma of the oesophagus usually develop?
It usually commences as an ulcer and spreads to become annular and constricting so the patient develops dysphagia
What is the prognosis for oesophageal cancer?
Prognosis is dependent on disease stage at presentation
5 year survival for cancers confined to the mucosa on presentation is 90%
5 year survival for patients with widespread local disease or systemic disease at presentation is < 10%
How is non-curable oesophageal cancer treated?
Palliative chemotherapy
Palliative chemoradiotherapy
Stent to improve swallowing function
