Category : Oncology

Pancreatic cancer ranks the 11th most common cancer in the world counting 458,918 new cases and 432,242 deaths in 2018. Worldwide incidence and mortality of pancreatic cancer increases with age, occurring moderately more often in in men than in women. Risk factors include cigarette smoking and family history. Two types of pancreatic cancer occur: pancreatic ..

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Indicaties voor verwijzing naar klinisch genetic bij patienten zonder colorectaal kanker (CRC) of polyposis  Persoon zonder CRC of polyposis met in de familieanamnese één van de volgende kenmerken: ·Eerstegraads familielid CRC < 50 jaar, (indien dit aangedane familielid zich zelf niet wil of kan laten verwijzen) ·Drie of meer (eerste- of tweedegraads) familieleden CRC (of ..

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Lynch syndrome (HNPCC) surveillance: European Society of Gastrointestinal Endoscopy (ESGE) recommendations -ESGE recommends starting colonoscopy surveillance atthe age of 25 years for MLH1 and MSH2 mutation carriersand at the age of 35 years for MSH6 and PMS2 mutationcarriers. -ESGE recommends a high quality surveillance colonoscopyevery 2 years in asymptomatic individuals with Lynchsyndrome. -ESGE does not ..

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Benign liver tumours Related articles:HCC treatmentRisk of liver decompensation after hepatectomy Haemangioma FNH HCA Estimated prevalence Common ~5%* Less common 0.03% Rare ≤0.004% Age 30–50 years 20–40 years All ages Gender F > M F ~ M F >> M US Hyperechoic Varied Varied CT Centripetal enhancement Central scar Varied MRI Centripetal enhancement Hyperintense T2-w ..

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Work-up anal carcinoma: -Rectoscopy with biopsies -MRI -Optional: Endoscopy ultrasound to inspect transmural invasion. -Optional: FDG-PET could be useful for stage evaluation and for a radiation plan. Treatment anal carcinoma based on stage: Tis: -Anal Intraepithelial Neoplasia (AIN): yearly check -AIN 2/3: treatment with electro- or infraredcoagulation. -Peri-anal AIN 2/3: Imiquimod cT1N0: -Curative surgery 1 ..

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Stage 1 (T1-2 N0M0):Wide surgical resection and anastomosis. No adjuvant chemotherapy. Stage II A, B, C (T3 N0 M0, T4 a-b N0 M0) -Wide surgical resection and anastomosis. -Following surgery, adjuvant therapy should not be routinely recommended for unselected patients. Stage III (any T, N1-N2, M0)-Wide surgical resection and anastomosis. -Following surgery, adjuvant chemotherapy Metastic ..

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Diagnostische criteria Peutz 1. Vaststelling van een mutatie in het STK11-gen 2. Op klinische gronden kan de diagnose gesteld worden bij: -Een positieve familie anamnese voor PJS, en ≥1 histologisch bevestigde PJS poliepen (hamartomen), of karakteristieke pigmentaties van huid en slijmvliezen -Een negatieve familie anamnese voor PJS, en ≥3 histologisch bevestigde PJS poliepen, of ≥1 ..

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Colonoscopy and gastroscopy surveillance recommendation for polyposis syndromes according to the ESGE guideline. Familial adenomatous polyposis (FAP); MUTYH-associated polyposis (MAP); Peutz-Jeghers syndrome (PJS); Juvenile polyposis syndrome (JPS); serrated polyposis syndrome (SPS) Related articles:Spigelman classificationLynch versus FAP References: Lorans, M., Dow, E., Macrae, F. A., Winship, I. M., & Buchanan, D. D. (2018). Update on Hereditary ..

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Neoadjuvant treatment: cT1-2N0 or cT3N0; 5 mm or less extramural invasion; distance to Mesorectal fascia > 1 mm: No neoadjuvant treatment cT1-3N1 or cT3N0; more than 5 mm extramural invasion; distance to Mesorectal fascia > 1 mm: 5x5Gy pre-operative radiotherapy\ cT4 or cT3; distance to Mesorectal fascia 1 mm or less and/or cN2/extramesorectal lymfnodes: Chemora..

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Work-up esophageal cancer: •Gastroscopy with biopsies •Thoracic and abdominal CT+ PET-CT • HER2, MSI-H/dMMR Regional lymph nodes: The regional lymph nodes, irrespective of the site of the primary tumour, are those in the oesophageal drainage areas including coeliac axis nodes and paraoesophageal nodes in the neck, but not supraclavicular nodes Limited disease (= cT1-T2 cN0M0) ..

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Leiomyoma Leiomyomas are smooth muscle tumour that are mostly benign. 1/1000 becomes cancer. The most likely sites are esophagus, stomach, small intestine and uterus, but they can occur in any organ. They are the most common benign mesenchymal tumour of the esophagus. The most common mesenchymal tumour of the small intestine and stomach is a ..

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Gastric cancer is one of the most common types of cancer. There are considerable geographical differences in incidence, with the highest in North-Eastern Asia. In the Netherlands the incidence is 7,3 per 100.000 people. 60% are male and it mostly occur above 70 years of age. Work-up:-Gastroscopy with biopsies-CT thoracic and abdominal-PET-CT-Diagnostic laparoscopy in patients ..

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A multicentre randomised phase II trial of neosurgery vs. neo-adjuvant chemotherapy followed by adjuvant chemotherapy and subsequent chemoradiotherapy followed by surgery vs. neo-adjuvant chemoradiotherapy followed by surgery in resectable gastric cancer References: Slagter AE, Jansen EPM, van Laarhoven HWM, et al. CRITICS-II: a multicentre randomised phase II trial of neo-adjuvant chemotherapy followed by surgery versus ..

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Type 1: Type 1 tumours (approximately 80% of total) are usually sessile polyps and associated with (usually autoimmune) atrophic gastritis, pernicious anaemia, achlorhydria and hypergastrinaemia, with the elevated gastrin being produced by gastric antral G cells. Type 2 gastric NETs (approximately 5% of total) occur in patients with Zollinger Ellison syndrome, usually in the setting ..

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References: Baker, A., Graham, T., Elia, G. et al. Characterization of LGR5 stem cells in colorectal adenomas and carcinomas. Sci Rep 5, 8654 (2015). https://doi.org/10.1038/srep08654 East JE, Atkin WS, Bateman AC, et alBritish Society of Gastroenterology position statement on serrated polyps in the colon and rectumGut 2017;66:1181-1196. Hardwick, J., Kodach, L., Offerhaus, G. et al. Bone morphogenetic protein signalling in colorectal cancer. Nat Rev Cancer 8, 806–8..

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