GI - Other Gastric Neoplasms Flashcards Preview

Year 3- Surgery > GI - Other Gastric Neoplasms > Flashcards

Flashcards in GI - Other Gastric Neoplasms Deck (11)
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1
Q

Identify 5 benign and 3 Malignant Gastric neoplasms

A
  • Benign: Benign polyps (adenomas), leiomyoma, lipomas, haemangiomas, schwannomas
  • Malignant: lymphoma, carcinoid, GIST
2
Q

Gastrointestinal stromal tumour (GIST): pathophysiology

A
  • Commonest mesenchymal tumour in GIT, >50% occur in stomach
  • Alice from intestinal cells of Cajal (pacemaker cells within bowel wall, located in muscularis propria)
  • OGD visualisation: well-demarcated spherical mass with central punctum
3
Q

Gastrointestinal stromal tumour (GIST): presentation and poor prognostic factors

A
  • Presentation: mass effects (abdo pain, obstruction) and ulceration (bleeding)
  • Poor factors: big size, extra-gastric location, high mitotic index
4
Q

Gastrointestinal stromal tumour (GIST): Mx - medical and surgical

A
  • Medical: if unresectable, recurrent or metastatic disease - can give Imatinib (kit selective tyrosine kinase inhibitor)
  • Surgical: resection
5
Q

What are carcinoid tumours?

A
  • Diverse group of neuro-endocrine tumours of enterochromaffin cell origin
  • May secrete multiple hormones
  • 10% occur in stomach
6
Q

What occurs with gastric carcinoids?

A

-Pt has atrophic gastritis —> decreased acid production —> increase in gastrin —> ECL hyperplasia —> carcinoid tumour

7
Q

What is a gastric lymphoma?

A
  • Commonest site for extranodal lymphoma
  • most commonly a MALToma due to chronic H pylori gastritis
  • H pylori eradication can be curative
8
Q

Zollinger-Ellison Syndrome: pathophysiology

A
  • Gastrimona most commonly found in small intestine or pancreas
  • Increased gastrin —> raised HCL = PUD and chronic diarrhoea
  • 60-90% of gastronomes are malignant
  • 25% are associated with MEN1
9
Q

Zollinger-Ellison Syndrome: presentation

A
  • Abdo pain/dyspepsia
  • Chronic diarrhoea/dyspepsia
  • Refractory PUD
10
Q

Zollinger-Ellison Syndrome: Ix

A
  • Raised gastrin associated with raised HLC (pH<2 in stomach)
  • MRI/CT
  • somatostatin receptor scintigraphy
11
Q

Zollinger-Ellison Syndrome: Rx

A
  • High dose PPI (60mg BD)

- Surgery: tumour resection or subtotal gastrectomy with Roux-en-Y

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