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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


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(general stump of carcinoma)

Definition: primary malignant neoplasm of oesophagus [any other organ(stump)]

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

Site: commonest site is middle 1/3 then lower 1/3 followed by upper 1/3 of oesophagus

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

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

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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