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GASTRIC MALIGNANCIES

GASTRIC MALIGNANCIES

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GASTRIC MALIGNANCIES

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  1. GASTRIC MALIGNANCIES Klara Matijević Mentor: A. Žmegač Horvat

  2. adenocarcinoma • gastrointestinal stromal tumours (GIST) • primary gastric lymphoma • gastric polyps

  3. ADENOCARCINOMA • 4th most common cancer world-wide • 2nd leading cause of cancer-related mortality • incidence increases with age (rare under the age of 30) • highest incidence: Eastern Asia (Japan), Eastern Europe, South America • men:women = 2:1

  4. Epidemiology • H.pylori infection (group 1 gastric carcinogen) • dietary factors • smoking tobacco • genetic abnormalities • increased risk after partial gastrectomy

  5. Diagram showing the development ofgastric cancer associated with H.pylori infection

  6. Pathology • Lauren classification: • intestinal type • diffuse type • diffuse carcinoma of linitis plastica type • gastric adenocarcinoma of intestinal type

  7. Borrmann classification: • polypoid • ulcerating • ulceroinfiltrative • infiltrative • gastric adenocarcinoma of ulcerative type • gastric adenocarcinoma of polypoid type

  8. Stage Grouping TNM classification:

  9. Clinical picture • advanced disease at the time of presentation • symptoms at early stage: • fullness in upper abdomen, nausea, anorexia • advanced disease symptoms: • epigastric pain, nausea, vomiting, dysphagia • weight loss • anemia (because of bleeding) • palpable lymph node – supraclavicular fossa (Virchow’s node)

  10. Diagnosis • patient history + physical examination • non-specific findings • lab findings • FBC + LFT • barium meal • ENDOSCOPY (EGD) !!! • staging: • chest X-ray • abdominal US • CT scan

  11. Treatment • endoscopic removal (only early non-ulcerated mucosal lesions) • surgery • chemotherapy • radiotherapy • palliative care

  12. GASTROINTESTINAL STROMAL TUMORS • GI mesenchymal tumors • asymptomatic, found by chance (ulceration, bleeding) • treatment: • surgery • chemotherapy if unresectable

  13. GASTRIC POLYPS • benign • rarely produce symptoms • types: • hyperplastic • adenomatous • cystic gland polyps • inflammatory fibroid polyps • treatment : endoscopic excision

  14. REFERENCES: • Kumar and Clark: Clinical Medicine (7th edition) • B.Vrhovac, B.Jakšić, Ž.Reiner, B.Vucelić: Interna medicina • www.pathconsultddx.com