- Most malignant lesions of the stomach are adenocarcinomas (95%). The rest are lymphomas and leiomyosarcomas.

Causes and Incidence The cause of stomach cancer is unknown but is thought to be related to dietary factors connected to food preservation and preparation. Gastritis, gastric atrophy, and genetic factors are believed to be predisposing factors. The incidence varies worldwide. Stomach cancer is the most common malignancy in Japan, and the incidence is extremely high in Iceland and Chile. The number of cases has declined significantly in western Europe and the United States. About 23,000 new cases are seen in the United States each year. The incidence is higher in men (2:1 ratio), in individuals 50 to 70 years of age, and in people of lower socioeconomic status.

Disease Process Cancer cells usually begin to grow in the distal end of the stomach in the lesser curvature. The cells form a tumor that spreads along the mucosa, eventually invading and moving through the stomach wall. The tumor then spreads directly to surrounding structures such as the spleen, esophagus, pancreas, colon, duodenum, and peritoneum. The cancer is also spread via the lymphatics to regional nodes and via the bloodstream to the liver.

Symptoms No specific symptoms appear in the early stages. Most people have generalized gastrointestinal (GI) complaints such as indigestion, burping, and fullness after eating. Later signs may include vomiting, dysphagia, anorexia, weight loss, and back pain.

Potential Complications The prognosis for long-term survival is poor (16%), primarily because most cases are diagnosed after metastasis has occurred. Complications include malnutrition and GI obstruction.

Diagnostic Tests Double-contrast x-ray studies of the stomach can delineate suspicious lesions. The definitive diagnosis is made by endoscopy with brush biopsy.

Treatments

Surgery
Excision of the tumor and regional lymph nodes; subtotal or total gastric resection or gastrectomy for resection for cure, depending on tumor location; gastroenterostomy for palliation.

Drugs
Systemic chemotherapy to treat advanced metastatic disease.

General
Radiation for palliation of GI obstruction.

Medi-Info.COM finds at this phrases

• paraplegic getting herpes
• phlebothrombosis
• symptoms of myxedema
• myxoedema medical
• mosquito urticaria
• diagnostic tests performed for epistaxis
• Medical Information

- Papillary carcinomas are the most common type of thyroid cancer (60% to 70%). Follicular carcinomas account for 15% to 20% of diagnosed cases, anaplastic carcinomas for 10%, and medullary carcinomas for less than 5%.

Causes and Incidence There is a strong link between radiation therapy to the neck region (a popular childhood treatment to shrink tonsils, adenoids, and thymus glands in the 1950s) and papillary cancer. Other suspected precursors of thyroid cancer include prolonged secretion of thyroid-stimulating hormone (TSH), iodine deficiencies, and chronic goiter. Familial predisposition (autosomal dominant trait) is strongly suspected in medullary cancer. About 10,000 cases of thyroid cancer are diagnosed in the United States each year. It can occur at any age, although anaplastic carcinoma is seen almost exclusively in the elderly. Thyroid cancer is two to three times more common in women than in men.

Disease Process Papillary and follicular carcinomas begin in the epithelial cells of the thyroid, growing slowly and forming nodules in the gland. Papillary tumors are usually nonencapsulated, extend to adjacent tissue beyond the thyroid, and metastasize to local cervical lymph nodes. Distant metastasis is rare. Follicular tumors are encapsulated, invade local tissue and cervical nodes, and metastasize to distant sites (e.g., lungs, bone) through the bloodstream.
Anaplastic carcinomas arise from the epithelium of the thyroid and are characterized by rapid, painful invasive growth to the trachea and major blood vessels, with metastasis to the bones and liver. Medullary carcinoma arises from the parafollicular cells of the thyroid and causes excessive secretion of calcitonin, lowering serum calcium and phosphate levels. Amyloid and calcium deposits are common. The tumor grows rapidly and metastasizes through lymphatics to cervical and mediastinal nodes and to the liver, lungs, and bone, leaving dense calcifications in its wake.

Symptoms The most common presenting sign is a palpable, symptomless lump in the neck.

Potential Complications The prognosis is excellent for papillary and follicular cancers if they are treated before distant metastasis occurs. Medullary and anaplastic cancers have a much higher death rate. Medullary tumors are treated successfully only if detected very early, before any tissue invasion is evident; anaplastic tumors are resistant to treatment and spread so rapidly they often cause death within 6 months of diagnosis. Complications include dysphagia, stridor, and tracheal obstruction.

Diagnostic Tests X-ray examination, thyroid scans, ultrasound and computed tomography scans, and magnetic resonance imaging are used to visualize the size and extent of the tumor and calcifications. A calcitonin assay for elevated levels of calcitonin is a reliable indicator for medullary carcinoma. The definitive diagnosis is made through fine needle aspiration biopsy.

Treatments

Surgery
Thyroidectomy with or without lymph node dissection as primary treatment; modified radical neck resection for recurrence or metastasis.

Drugs
Palliative treatment in widespread disease; thyroid hormone as replacement therapy and to suppress TSH production.

General
Radioactive iodine ablation as adjuvant to surgery or alone for palliation; instruction about lifelong use of thyroid replacement hormones.

Medi-Info.COM finds at this phrases

• myxedema signs and symptoms
• skin growth quadriplegic wounds
• hives and kidney stones
• hives after tb test
• myxedema signs symptoms
• The disease process of Meningitis

- Adenocarcinomas account for most endometrial cancer; other tumor types include adenoacanthoma and clear cell and squamous cell tumors.

Causes and Incidence The cause of endometrial cancer has not yet been firmly established although a long-established link exists to hormone-related disorders. However, approximately 40% of endometrial tumors appear to be autonomous with no known etiology. Associated risk factors include adenomatous hyperplasia of the endometrium, menstrual irregularities, delayed menopause, infertility, diabetes or hypertension, and a history of breast or ovarian cancer.
Endometrial cancer is the most common of the gynecologic malignancies, with more than 31,000 new cases a year in the United States. This cancer is found primarily in postmenopausal women between 55 and 60 years of age. The women tend to be from highly industrialized countries, and the prevalence has increased sharply.

Disease Process Cells begin as endometrial hyperplasia and change to cancer cells, beginning in the fundus of the uterus and spreading to the entire endometrium. The tumor may then extend down the endocervical canal and involve the cervix and vagina. It also spreads through the uterine wall to the abdominal cavity and adjacent structures and metastasizes to the pelvic and paraaortic lymph nodes, lungs, bone, and brain.

Symptoms The only significant clinical sign of endometrial cancer is inappropriate uterine bleeding. Approximately one third of postmenopausal women who experience such bleeding have endometrial cancer.

Potential Complications Advanced disease leads to complications such as bowel obstruction, ascites, and respiratory distress, and the prognosis is poor.

Diagnostic Tests A Papanicolaou smear is helpful but undependable, because 30% to 40% of smears yield false-negative results. Malignant cells on endometrial biopsy and fractional curettage yield a definitive diagnosis.

Treatments

Surgery
Hysterectomy

Drugs
Chemotherapy for recurrent lesions and metastasis; hormones (e.g., progestin) to treat metastasis or precancerous lesions.

General
Radiation as adjunct to surgery and palliation; counseling for body image and sexual functioning alterations.

Medi-Info.COM finds at this phrases

• pathophysiology of viral hepatitis
• disease process of tuberculosis
• heina hernia
• pediculosis symptoms
• myxedema hypothyroidism
• hyena hernia