2. Definition
Neoplasm is an abnormal mass of tissue, the growth of which exceeds and is
uncoordinated with that of the normal tissues and persists in the same
excessive manner even after cessation of the stimuli.
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3. Classification
Benign Malignant
Well-differentiated Lack of differentiation
Smooth, slow, progressive rate of
growth
Erratic, rapid growth
Well localized and capsulated Not capsulated
Do not infiltrate surrounding normal
tissue
Infiltrate the surrounding tissues
No metastasis Metastasize through lymphatics or blood
Curable May be not completely curable
No recurrence Recurrence can occur
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5. AETIOLOGIC FACTORS
Alkylating agents (Altretamine, Cisplatin, Chlorambucil etc.)
Hydrocarbons(Polycyclic Aromatic Hydrocarbons)
Smoking:-lung, aerodigestive system, bladder cancer
Asbestos
There is sufficient evidence that asbestos causes mesothelioma
Alcohol
Regular heavy alcohol use can damage the liver, leading to inflammation
and scarring. Alcohol use has been linked with a higher risk of cancers of colon
and rectum.
Amides ,Azo dye:-bladder cancer
Aflatoxin
Generally found in foods such as groundnuts, maize, rice, crude vegetable
oils with fungal contamination. Exposure to it associated with an increased risk
of of liver cancer.
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6. 6
Arecoline, collagenases and tannins (present in
betel nuts)
Consumption of these cause esophageal cancer
Nitrosamines, vinyl chloride, insecticides
Exposure to these is associated with liver, brain
and lung cancer, lymphoma and leukemia
UV rays, ionizing radiation:- skin cancer
Human papilloma virus-carcinoma cervix
Epstein-Barr virus-Burkitt’s lymphoma,
nasopharyngeal carcinoma
Hepatitis B virus-liver cancer
HumanT cell leukemia virus type-I
Helicobacter pylori can cause carcinoma of stomach
and is associated with lymphomas
7. Spread of malignant tumors
1. Local spread: Into adjacent structures like soft tissues, vessels, bone.
1. Lymphatic spread
By permeation: Here malignant cells proliferate through lymphatic vessels up to node
level
By embolization: Here cells get disclosed from lymphatic vessel and freely travel to
spread into further level of lymph nodes.
Retrograde lymphatic spread occurs once lymph vessel get blocked by malignant
infiltration.
3. Blood spread
Occurs through veins, as veins are thin walled and infiltration is easier (Arteries contain
elastic fibers in their wall, which resist malignant infiltration). Blood spread is commonly to
lungs, bone (upper end of femur, ribs, skull), liver, brain adrenals.
4. Transcoelomic spread: Krukenberg tumor
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8. Staging of the tumor
It is based on the
1. Size of the primary tumor
2. Nodal spread and
3. Blood spread
It is called as ‘TNM’ staging.
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11. Contd……
INVESTIGATIONS FOR NEOPLASM
2) Immunohistochemistry:
It is detection of specific antigen using antibody. Antibody labelled with a dye, binds to
antigen in a section of tissue causing specific colors like brown, and determines its presence and
distribution in the tissues.
Detection of receptors or molecules, e.g. estrogen receptors [ER] in breast cancer
3) Other methods
Electron microscopy: It is visualization of tissue in very high magnification of 1000*500000 in
difficult deciding cases.
In situ Hybridization: It is determination of presence or absence of a specific gene and its location in
a fixed/fresh tissue sections using an oligonucleotide probe, targeting at specific DNA or RNA
sequence.
Polymerase Chain Reaction(PCR): DNA is amplified using this special method and detected by
technique like electrophoresis.
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12. MANAGEMENT STRATEGY FOR NEOPLASM
1. Diagnosis is confirmed by biopsy from primary usually.
2. Evaluations for staging-metastatic work up.
3. Approaches for primary-surgery/radiotherapy/chemotherapy.
4. Approaches for secondary.
5. Palliation in advance stage-palliation of distressing symptoms.
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14. CURABLE MALIGNANCIES
1. Basal cell carcinoma
A type of skin cancer that most often develops on areas of
skin exposed to the sun, such as the face.
2. Adamantinoma
Slow-growing cancerous bone tumors that form primarily
in the tibia (shin bone) but occasionally in the jaw, forearm,
hands, or feet.
3.Verrucous carcinoma
A rare and highly treatable cancer that usually occurs in your
mouth (oral cavity) and occasionally on your genitals or feet.
4. Marjolin’s ulcer
A cutaneous malignancy that arises in the setting of
previously injured skin, longstanding scars, and chronic wounds.
5. Papillary carcinoma of thyroid
The most common cancer of the thyroid gland.The
thyroid gland is located inside the front of the lower neck.
6.Carcinoma colon
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