Oncology Flashcards
example of hypertrophy and hyperplasia in Male/Female
BPH
Breast
Ananplasia
revert to mesenchymal origin
very aggressive
high metastatic rate
sensitive to radiation or chemo
Desmoplasia
cartilaginous tissue surrounds the tumor
metaplasia
adult cell to another adult cell which can handle the stress
Dysplasia
loss of cell-to-cell contact inhibition
CIN
good prognosis (90% 5-yr survival)
Best time to screen
neoplasia
new growth
Tumor, mass, neoplasia
Benign first then malignant second
When it has been removed (in the question)
cancer first then benign
well circumscribed, encapsulated, response to normal physiological, freely mobile
Benign
adherent, outgrows blood supply, no circumscribed, does not obey physiological
Malignant
Malignant hormone
Angiogenin: grow own blood supply
Endostatin: Stops growth of bld vessels to other cancer
when is chemo considered effective
kill up to a billion cells
(cancer is palpable and visible )
when cancer out grows its blood supply what happens
metastases
where is metastasis primary cancer
Brain
bone
lung
liver
pericardium
adrenal
example of hamartomas
keloid, polyps
too much normal tissue
abnormal location of normal tissue
choriostoma
all cancers are low energy state…so…
mcc of death in cancer
infection
MC intracranial tumor
meningioma
Psammoma bodies (calcifications)
cancers that have Psammoma Bodies
Papillary carcinoma of thyroid
serous cystic
Adeocarcinoma of the ovaries
Meningioma
Mesothelioma
MC Primary brain tumor
Astrocytoma
Glioma
Oligodendroglioma
Ependymoma
ependymoma seeing in
Ventricular system :hydrocephalus
Neurocutaneous syndromes different in their
cutaneous manifestation
NF
Cafe au lait spots
17/22
Neuromas
Fibromas
NF: MaCune-Albright syndrome
Precocious puberty
Fibrous bone tumors
NF: Sturge-weber syndrom
Port wine stain on the forehead
Angiomas of the retina and brain
Tuberous sclerosis
Ashen leaf spots (hypopigmented)
Phabdomyoma/Rhabdomyosarcoma of the heart
Renal Cell Carcinoma
Primary brain tumor
MC Primary brain cancer
astrocytoma grade IV or Glioblastoma multiforme
MC Brain cancer
Metastases
at grey-white matter junction
Met in women
Breast , Lung and Colon
MC tumor in the Pituitary is
Adenoma
Acidophils adenomas produces
Prolactin and Growth Hormone
Basophils adenomas produces
ACTH, TSH, FSH , LH
MC functional pituitary adenoma
Prolactinoma
MC Cancer of the pituitary
Adenocarcinoma(rare)
non functional pituitary tumor
chromophobes (95%)
tumor that affect cranial Nerve 6(esotropia)
Pinealoma(pineal adenoma)
cause precocious puberty
mc pineal cancer
adenocarcinoma(rare)
Present with early morning vomiting
mc in children
posterior Fossa Tumors
Posterior fossa tumors with cerebellar origin
Medulloblastoma
develops from Rathke’s Pouch
motor oil appearance
affects pituitary
Craniopharyngioma
mc abdominal mass in newborn
enlarge bladder
MC abdominal mass in children
neuroblastoma
hypsarrhythmia and opsoclonus
neuroblastoma
pheochromocytoma Lab
VMA and HVA
paroxysmal palpitations, HTN, headache and diaphoresis
pheo, neuroblastoma
Phentolamine and phenoxybenzamine in
Pheochomocytoma
masses of the anterior mediastinum
Thymus
Thyroid
T-Cell leukemias/Lymphomas
Teratomas
98% of leukemia are
B-cell
Hairy cell Leukemia
B-cell 75%
T-cell 25%
TRAP Pos
2 pure T-Cell Lymphoma
Mycosis fungoides(skin Rash)
Sezary syndrome
mc thymic tumor
thymoma
what disease is thymoma not associated with
Graves
Thyroid MC mass
Thyroglossal cyst
MC Thyroid tumor
Follicular adenoma
MC thyroid cancer
Papillary carcinoma
risk radiation to the neck
Solid hot thyroid mass next step
treat like hyperthyroidism
MC thyroid mass
thyroglossal cyst
Treatment for Graves disease (Hot nodule)
Propranolol
Prothyrouracil (PTU: pregnancy)
Methimazole(highly fat-soluble)
Iodine 131(destroys the thyroid)
cold nodule next step
biopsy
MCC of Parathyroid deficiency
thyroidectomy
MC tumor of the parathyroid
parathyroid adenoma
what is the MCC of isolated hypercalcemia in adults
parathyroid adenoma
MC cancer of parathyroid
adenocarcinoma
Tumor of MEN 1
Pituitary
Pancreatic
parathyroid
Tumors of MEN 2
medullary carcinoma of thyroid
pheochromocytoma
(+/-) parathyroid adenomas
Ret mutation
Tumors of MEN 2B
MEN2A plus Nuroma or
ganflioneuroma but w/o PTH adenomas
Marfenoid
Ret Mutation
high calcitonin, hypocalcemia, neck mass
Medullary carcinoma of the thyroid
parafollicular gland tumor
adenoma
contents of the mediastinum
heart: endocardium,
myocardium and
epicardium
pericardium
diastolic plop
middle age female who passes out and recovers in few seconds
Estrogen connection (relaxes and vasodilation/increase volume
tumor of the endocardium
myxoma (mc location: Left atrium)
mc Carcer of the endocardium
angiosarcoma(rare)
Myocardium tumor and cancer
Rhabdomyoma
Rhabdomyosarcoma(Tuberous sclerosis)
MC cancer of the pericardium
Metastases
MC tumor of pericardium
Fibroma
Mc lung mass in children and adult
Hamartoma
Granulomas
MC cancer of the lung
metastases
MC lung tumor
Adenoma
Mc intrathoracic cancer
squamous cell carcinoma
mc primary lung cancer
bronchogenic adenocarcinoma
primary lung cancer not related to smoking
brochoalveolar adenocarcinoma
Risk factor for lung cancer
smoking
Radon
secondhand smoke
side stream smoke
mainstream smoke
all pneumoconiosis increase risk of cancer except
anthracosis
central lung cancer
Small cell and squamous cell
associated with smoking
ferruginous bodies associated with
mesothelioma
Nasal polyp seen in pt indicates
high sensitivity
avoid aspirin (NSAIDS) therapy
MC cancer of the nasopharynx
Nasopharyngeal carcinoma
common in Chinese women
Nasopharyngeal carcinoma is asso with which virus
EBV
cancer on the floor of the mouth, lower lips and tip of the tongue
squamous cell carcinoma
mc cancer of lower 1/3rd of esophagus
adenocarcinoma
Barret’s esophagus is example of what cellular changes
metaplasia
seen with adenocarcinoma of the stomach
Virchow’s nodes
linitis plastica
signet ring cells
kruckenberg tumor
Risk factor for UGI Cancer
Smoking
alcohol
Nitrites
Japanese people
MC cancer of the ileum
lymphoma
70% of lymphoid tissue found in ileum
mc cancer of the appendix
carcinoid (does not metastasize)
MC origin of carcinoid syndrome
1) Pancreas
2) Ileum
secretes massive serotonin
urinary 5-HIAA indicates
carcinoid syndrome
high serotonin
Napkin ring lesion found in
small intestine
Colon
Eaten apple core lesion
pencil thin stools
melena
Colon cancer:adenocarcinoma
colon cancer risk factor
Low fiber diet
High fat diet
polyps
ulcerative colitis
mc mass in the liver
cyst
polyposis, hyperpigmented mucosa
Peutz-jeghers syndrome
familiar polyposis and brain tumors
turcot’s
Familia polyposis, osteomas, and sebaceous adenomas
gardner’s syndrome
mc tumor of the liver
adenoma and AVMs
Mc cancer of the liver
metastases
primary cancer of the liver
hepatocellular adenocarcinoma
acute life-threatening hemorrhage
ruptures in increased abdominal pressure (weightlifter)
associated with
estrogen use or steroid injection
hepatic adenoma
increase venous O2
decreased AVO2 difference
AVM
abnormal arteries—veins connection
AVM syndromes: multiple AVM
Osler- weber- Rendu: Lungs
Von Hipel Lindau:abdomen and brain
AVM cancer in Kidney?
gene?
Renal cell carcinoma
Chromosome 3p
VHL gene
massive dilation of the colon
toxic megacolon: maybe due to cancer obstruction
premalignant polyps in adults
- Tubular
- Tubulovillous
- villous: worse b/c it is eating through the lining
familial polyposis risk
100% cancer risk
year screening at age 5
total colectomy at age 19
what murmur is heard in AVMs
continuous murmur
vinyl chloride is risk factor for
Angiosarcoma of liver (highly malignant)
Aniline dyes, Benzene, aflatoxin risk factor for
hepatocelluar carcinoma
infectious risk factor for hepatocellular carcinoma
Hep B, C, schistosomiases
Biliary tract mass
choledochal cyst
most common tumor of biliary tract
cholangioma
MC biliary cancer
cholangiosarcoma
marker for primary biliary cirrhosis
Antimitochondrial antibodies
mid age female with itching and severe fatigue
sclerosing cholangitis is seen in
ulcerative colitis
HLA B27
Pos P-Anca
migratory thrombophlebitis
the most mucious cancer
pancreatic adenocarcinoma
Cancer causing cholestatic jaundice, high direct (conjugated) bilirubin
pancreatic adenocarcinoma
MC tumor of the pancreas
adenoma
high glucose
high Lipids
high Ketones
necrolytic skin lesion
Glucagonoma
high insulin
high C-peptite
Insulinoma
sufanourea
neoplasm with severe constipation
somatostatinoma
neoplasm with watery diarrhea
Vipoma
elevated gastrin
worse with secretin
ulcer in distal small intestine dt low pH
Gastrinoma (Z-E syndrome)
follicular cyst
MC mass of ovary
serous cysadenoma
mc tumor of ovary
serous cystadenocarcinoma(highly malignant)
most mucinous cancer in women
mc ovarian cancer
meigs’s syndrome (ovarian fibroma) causes
pleural effusion or ascites
Granulosa cell tumor causes
elevated estrogen levels
estrogen connection
Yolk sack cancer marker
high AFP
Choriocarcinoma marker
High HCG
Tumor: masculinization (high testosterone)
Sertoli-Leydig cell tumor
pseudomyxoma peritonei:very mucinous
cystadenocarcinoma
struma ovarii: Grave like disease with no thyroid mass
Teratoma
elevated serum lactic dehydrogenase
dysgerminoma/seminoma
embryonal cell carcinoma
uterine polyp presents with
passing of blood clots
Uterus: focal thickening, firm mass
estrogen dependent tumor
fibroid
submucosal (90%) fibroid
menorrhagia
fibroid RX
OCPs
Leuprolide(GnRh analogue)
Surgery (uterine artery embolization)
subserosal fibroids presents with
pelvic pain or pressure
metrorrhagia after 35, estrogen dependent
endometrial adenocarcinoma
mc mass of the cervix
warts
mc tumor of the cervix
fibroma
mc cervical cancer
squamous cell carcinoma
condyloma lata seen with:
2nd to syphilis
fleshy appearance
condyloma acuminatum
HPV 6/11
verrucous or mushroom-like warts
Warts RX
Trichloroacetic acid for internal warts
podophyllum drops for external warts
cryosurgery
Cervical cancer RX
hysterectomy
Cervical cancer risk
HPV(16/18)
STIs
mc mass of the vagina
warts
Bartholin cyst
mc vaginal tumor
fibroma
mc vaginal cancer upper half
squamous cell carcinoma of cervix
mc vaginal cancer lower half
Rhabdomyosarcoma (sarcoma botryoides)
fluctuant mass behind the labia major
bartholin cyst
complication of bartholin cyst, Rx
infections/abscess formation
RX antibiotics
fluctuant mass behind labia majora after 50yo, next step
Bartholin cyst
resect and check for cancer
Sarcoma botryoides has increased incidence of
Tuberous sclerosis
under age 3
Mc kidney cancer in
Children
Adult
Wilms’ tumor
Renal cell adenocarcinoma
mental retardation, aniridia and hemihypertrophy in children
wilms’ tumor in kids
Renal cell carcinoma presentation
painless hematuria and flank mass(+/- HTN)
superior pole of kidney
How does Renal cell Carcinoma metastasize
retroperitoneum
Renal cell carcinoma may produce
erythropoietin
angiogenin (high vascular ability)
cannon ball met to the lungs
Renal cell carcinoma
Renal cell carcinoma risk factor
smoking
VHL
Tuberous Sclerosis
aldosterone producing tumor
conn’s syndrome
cortisol producing tumor
adrenal adenomas: Cushing’s syndrome
pheochromocytoma mc location
adrenal medulla
transitional cell adenocarcinoma
mc bladder cancer
mc bladder mass
diverticulum
bladder diverticulum complications
UTIs and kidney stones
Painless hematuria exposure to smoke, aniline dyes, benzene, cyclophosphamide…
Bladder cancer: transitional adenocarcinoma
schistosoma haematobium causes (bladder complication)
squamous cell carcinoma
weak, dribbling urination and straining, increase frequency and urgency
BPH
BPH RX
Terazosin/Doxazocin
Tamsulosin
Finasteride/Dutasteride
TURP
Prostate cancer screening
age 35: baseline rectal exam
age 40- annual rectal/ FOBT
45: sigmoidoscopy and every 5 years
50: colonoscopy every 10 years
first-degree relative: colon screening at 40
mc testicular mass in newborn
hydrocele
mc testicular mass in adolescence and older
varicocele
mc testicular mass in children
hematoma
mc testicular tumor
adenoma
Testicular cancer 1st year of life
yolk sack cancer
mc testicular cancer: teen to adult. Highly malignant
Seminoma
all neurocutaneous disease have
mental retardation
cerebral calcifications
seizures
Next step for any firm testicular mass
orchiectomy
Breast Mass treatment
surgery
tamoxifen/Raloxifene (estrogen +)
chemotherapy : premenopausal
Radiation: post menopausal
bleeding nipple
intraductal papilloma
Breast:cells lined up in single file
Lobular adenocarcinoma
comedocarcinoma
focal areas of necrosis
peau d’orange(lymphatics intiltration) most malignant
inflammatory adenocarcinoma
exploding sarcoma that stops growing
cystosarcoma
located in upper outer quadrant and nipple
presents with dimple
intraductal adenocarcinoma
Rash or ulcer around nipple
Paget’s disease
Osteolytic or osteoblastic met from breast
intraductal adenocarcinoma
estogen and progest dependent
Greenish fluid on aspiration, enlarges last two week of menses
fibrocystic disease
progesterone dependent
Enlarges first two weeks of menses
fibroadenomas
estrogen dependent
mc breast tumor below 25(estrogen)
fibroadenoma
mc breast tumor above 25 (progest)
fibrocystic disease
Rouleaux formation, Hypercalcemia, Kappa, IG-g
Multiple myeloma
Plasmacytoma (single lesion)
onion skinning on childs X-ray
Ewing’s osteosarcoma
T(11/22)
mc bone cancer
mets
mc diaphyseal and metaphyseal cancer
mets
starburst cortex, codman’s triangle in adults
metaphyseal: osteosarcoma
chondrosarcoma
mc cancer of epiphysis
actinic keratosis, Bowen’s disease indicate possible
squamous cell carcinoma
ulcerative lesions
what disease might increase risk of squamous cell carcinoma
Job’s, syndrome, albinism, porphyria cutanea tarda;, PKU, Wiskott-Aldrich
Mc skin cancer that does not behave malignantly
Basal cell carcinoma
Mc malignant skin cancer
melanoma
