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Klara Matijević Mentor: A. Žmegač Horvat.  adenocarcinoma  gastrointestinal stromal tumours (GIST)  primary gastric lymphoma  gastric polyps.

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Presentation on theme: "Klara Matijević Mentor: A. Žmegač Horvat.  adenocarcinoma  gastrointestinal stromal tumours (GIST)  primary gastric lymphoma  gastric polyps."— Presentation transcript:

1 Klara Matijević Mentor: A. Žmegač Horvat

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

3  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

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

6 Normal gastric mucosa H.Pylori infection Acute gastritis Chronic active gastritis Atrophic gastritis Intestinal metaplasia Dysplasia Advanced gastric cancer Diagram showing the development of gastric cancer associated with H.pylori infection

7 Lauren classification: intestinal type diffuse type diffuse carcinoma of linitis plastica type gastric adenocarcinoma of intestinal type

8 Borrmann classification: polypoid ulcerating ulceroinfiltrative infiltrative gastric adenocarcinoma of polypoid type gastric adenocarcinoma of ulcerative type

9 TNM classification:. Stage 0TisN0M0 Stage IAT1N0M0 Stage IBT1N1M0 T2a/bN0M0 Stage IIT1N2M0 T2a/bN1M0 T3N0M0 Stage IIIAT2a/bN2M0 T3N1M0 T4N0M0 Stage IIIBT3N2M0 Stage IVT4N1–3M0 T1–3N3M0 Any TAny NM1 Stage Grouping

10  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)

11 1. patient history + physical examination  non-specific findings 2. lab findings  FBC + LFT 3. barium meal 4. ENDOSCOPY (EGD) !!! 5. staging: chest X-ray abdominal US CT scan

12  endoscopic removal (only early non- ulcerated mucosal lesions)  surgery  chemotherapy  radiotherapy  palliative care

13  GI mesenchymal tumors  asymptomatic, found by chance (ulceration, bleeding)  treatment: surgery chemotherapy if unresectable

14  benign  rarely produce symptoms  types: hyperplastic adenomatous cystic gland polyps inflammatory fibroid polyps  treatment : endoscopic excision

15  Kumar and Clark: Clinical Medicine (7th edition)  B.Vrhovac, B.Jakšić, Ž.Reiner, B.Vucelić: Interna medicina 


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