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Discuss oesophageal carcinoma in details

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1Discuss oesophageal carcinoma in details Empty Discuss oesophageal carcinoma in details Sat Mar 10, 2012 4:49 am

ismipahmie

ismipahmie
Star Member
Star Member

(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

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