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25 Cards in this Set
- Front
- Back
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What is tumor angiogenesis?
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The growth of new blood vesels into the tumor. Essential for tumor growth beyond 1-2 mm^3 in size
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What is the diffusion limit of oxygen in relation to tumor size?
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100-200 micrometers
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Steps in tumor invasion?
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Detachment (E-cadherin), Adhesion to ECM (integrins, laminin receptors, CD44), Proteolytic degradation of ECM (MMP, plasminogen activator, cathepsins, heparanase), & motility/migration (autocrine motility factor)
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What may protect metastasized cells from immune detection?
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Fibrin-encased tumor thrombus. Metastasis suppressor gene
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What are the target organs in metastatic disease?
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Spread can’t be predicted solely based on anatomy. Requires favorable envir. Eg lung ca->brain. GI ca-> liver.
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What organs are not freq sites of metastasis?
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Spleen & skeletal muscle
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Local effects of a tumor
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Location/ compression of vital organs, Obstruction of the GI or GU tract, Ulceration of mucosal and/or serosal surfaces, Secondary bleeding and/or infection, Increased pressure in confined space, Nerve invasion
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Systemic effects of a tumor
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Secretion of hormones by the tumor cells (topic; from native cells or ectopic). Paraneoplastic syndromes
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Endocrine effects of topic tumors?
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Pituitary (ACTH, GH, TSH, PL), Adrenal (GC & MC), Thyroid (Thyroxin), Gonads (estrogen & androgens), Pancreas (insulin, glucagon, gastrin, VIP, Somatastatin), kidney (erythropoetin)
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Endocrine effects of ectopic tumors?
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small cell ca of lungs (ACTH, ADH-like, PTHrP), Bronchial carcinoid (serotonin), Sarcoma (insulin-like), Ovarian (thyroid)
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Charac of paraneoplastic syndromes?
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~10% patients with cancer. They may represent the earliest manifestation of an occult neoplasm. They may produce significant morbidity and may even be lethal. They may mimic metastatic disease or other disease processes
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What is Cushing's syndrome?
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"One of most common paraneoplastic endocrinopathies. 50% of patients have carcinoma of the lung (small cell carcinoma). Excessive production of ACTH or ACTH-like peptide
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Whats the diff b/w Cushing disease & syndrome?
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The syndrome is caused by anything other than the pituitary
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Symptoms of Cushings Syndrome
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Obesity, Hypertension, Plethora, Abnormal fat distribution, Buffalo hump, Moon facies, Abdominal striae, In female, masculization
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What are some paraneoplastic vascular & hematologic disorders?
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Migratory thrombophlebitis (pancreatic, bronchogenic ca), DIC (acute promyelocytic leukemia, prostatic ca), nonbacterial thrombotic endocarditis (advanced mucin-producing ca)
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Paraneoplastic dermatological disorders?
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Acanthosis Nigricans (Gastric, lung, uterine ca) & Dermatological disorders (breast, bronchogenic ca)
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Paraneoplastic bone & soft tissue disorders?
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Hypertrophic osteoarthropathy & clubbing of the fingers (bronchgenic ca
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Tumor that causes Cushing's syndrome
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Small cell ca of lungs, pancreatic ca, neural tumors
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Tumor that causes syndrome of inappropriate ADH secretion
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Small cell ca of the lungs, intracranial neoplasms
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Tumors that causes hypercalcemia
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Squamous cell ca of the lungs, breast ca, reanl ca, ovarian ca
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Tumor that causes hypoglycemia
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Fibrosarcoma & other sarcomas, hepatocellular ca
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Tumor that causes carcinoid syndrome?
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Bronchial adenoma, pancreatic ca, gastric ca
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Tumor that causes polycythemia?
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Renal ca, cerebellar hemangioma, hepatocellular ca
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What is cancer cachexia?
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Progressive body weight loss (Body fat & lean body mass. Different from starvation). Profound weakness, anorexia and anemia (NOT due to the nutritional demands of the tumor or decreased intake alone)
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What cytokines are produced as a result of cachexia?
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Production of cytokines and other soluble factors. TNF-alpha, IL-1, INF-gamma. Loss of appetite, inc metabolic rate in spite of dec intake. Equal loss of fat and muscle
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