(general stump of carcinoma)
Definition: primary malignant neoplasm of oesophagus [any other organ(stump)]
Aetiology:
The exact aetiology is unknown however the following are the predisposing factors:
1. Sex: more in male except in post cricoids carcinoma which predominates female
2. Age: above 40
3. Benign papilloma change to malignant
4. chronic trauma: habits of ingestion spicy food and alcohol
5. Others:
• Achalasia of lower third of oesophagus
• Barrett`s oesophagus
• Smoking
• Plummer- Vinson syndrome
• Vitamins defiency
Pathology:
Site: commonest site is middle 1/3 then lower 1/3 followed by upper 1/3 of oesophagus
Macro(gross):
1) Infiltrating pattern leading to annular stricture( put this first because oesophagus is a hollow organ)
2) Ulcerating with irregular shaped with raised everted edge, necrotic floor and indurated base
3) Polypoid fungating cauliflower like friable necrotic mass with wide base
Micro:
1) Commonly squamous cell carcinoma with hyperchromatism, pleomorphism, prominent nucleoli, increase N/C ratio and abnormal mitotic figure
2) Adenocarcinoma if originate from lower 1/3 of oesophagus
Complications:
1) Hemotemesis
2) Secondary bacterial infection
3) Spread:
• Direct to surrounding: mediastinal structures and trachea
• Early with lymphatic: to supraclavicular and mediastinal lymph node
• Late with blood: to lungs, livers and others
4) Dysphagia
5) Others: trachea-oesophageal fistula
Definition: primary malignant neoplasm of oesophagus [any other organ(stump)]
Aetiology:
The exact aetiology is unknown however the following are the predisposing factors:
1. Sex: more in male except in post cricoids carcinoma which predominates female
2. Age: above 40
3. Benign papilloma change to malignant
4. chronic trauma: habits of ingestion spicy food and alcohol
5. Others:
• Achalasia of lower third of oesophagus
• Barrett`s oesophagus
• Smoking
• Plummer- Vinson syndrome
• Vitamins defiency
Pathology:
Site: commonest site is middle 1/3 then lower 1/3 followed by upper 1/3 of oesophagus
Macro(gross):
1) Infiltrating pattern leading to annular stricture( put this first because oesophagus is a hollow organ)
2) Ulcerating with irregular shaped with raised everted edge, necrotic floor and indurated base
3) Polypoid fungating cauliflower like friable necrotic mass with wide base
Micro:
1) Commonly squamous cell carcinoma with hyperchromatism, pleomorphism, prominent nucleoli, increase N/C ratio and abnormal mitotic figure
2) Adenocarcinoma if originate from lower 1/3 of oesophagus
Complications:
1) Hemotemesis
2) Secondary bacterial infection
3) Spread:
• Direct to surrounding: mediastinal structures and trachea
• Early with lymphatic: to supraclavicular and mediastinal lymph node
• Late with blood: to lungs, livers and others
4) Dysphagia
5) Others: trachea-oesophageal fistula
