logging in or signing up 5ANORECTAL CARCINOMA drvinayshahapurkar Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 49 Category: Education License: All Rights Reserved Like it (0) Dislike it (0) Added: December 05, 2011 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript ANORECTAL MALIGNENCY: ANORECTAL MALIGNENCY DR.V.V.SHAHAPURKAR PROF.DEPT. OF SURGERY DMIMSLearning objectives : Learning objectives Carcinoma of rectum is common and its symptoms are similar to those of benign diseases and , hence, patients with such symptoms must be evaluated carefullyPowerPoint Presentation: INCIDENCE- 70 % IN RECTUM AND RECTO SIGMOID REGION ONE THIRD CAN BE PALPATED DIGITITAL EXAMINATION AND 60% CAN BE VISUALISED BY SIGMOIDOSCOPY NEXT TO STOMACH CANCER IN INDIAPowerPoint Presentation: Typical sites of incidence and sympoms of colon cancerPowerPoint Presentation: Risk factors for RC Age Adenomas, Polyps Sedentary lifestyle, Diet, Obesity Family History of RC Inflammatory Bowel Disease (IBD) Hereditary Syndromes (familial adenomatous polyposis (FAP))PowerPoint Presentation: result of interplay between environmental and genetic factors Central environmental factors: diet and lifestyle 35% of all cancers are attributable to diet 50%-75% of RC in the INDIA may be preventable through dietary modifications Development of RCPowerPoint Presentation: consumption of red meat animal and saturated fat refined carbohydrates alcohol increased risk Dietary factors implicated in rectal carcinogenesisPowerPoint Presentation: dietary fiber vegetables fruits antioxidant vitamins calcium folate (B Vitamin) decreased risk Dietary factors implicated in rectal carcinogenesisPATHOLOGY: PATHOLOGY MAJORITY ADENOCARCINOMA RARE SQUAMOUS CELL CARCINOMA, MALIGNANT MELANOMA, AND LEOMYOSARCOMA.ADENOCARCINOMA : ADENOCARCINOMA WELL DIFFERENTIATED MODERATELY DIFFERENTIATED POORLY DIFFERENTIATED MACROSCOPIC - ULCERATIVE POLYPOID (CAULIFLOWER) ANNULAR (INFILTRATING)ULCERATIVE : ULCERATIVE TYPICAL MALIGNANT ULCER WITH RAISED, ROLLED OUT EVERTED EDGES AND EXCAVATED FLOOR POLYPOID _ AT AMPULLA OF THE RECTUM ANNULAR _ AT RECTOSIGMOID REGIONSPREAD : SPREAD DIRECT SPREAD _ ULCERATIVE MURAL INFIL SPREADS TO SURROUNDING FAT TRATION POLYPOID LESION _ LATE MURAL SPREAD ANNULAR CIRCUMFERENCIAL SPREAD ONCE MUSCULAR COAT PENETRATED GROWTH TO SURROUNDING FAT PERIRECTAL FASCIA (DENONVILLIER) INVOLVE IN ADVANCE CASE .LYMPHATIC SPREAD: LYMPHATIC SPREAD PARARECTAL NODES INTERMEDIATE NODES ALONG THE LOWER PART OF SUPERIOR RECTAL ARTERY AND ITS BRANCHES CENTRAL NODES AT ORIGIN OF INFERIOR MESENTRIC ARTERYPowerPoint Presentation: ABOVE THE PERITONEAL REFLECTION AND BELOW THE PERITONEAL REFLECTION SPREAD IS UPWORD LOWER DOWN LATERALLY TOWARDS PELVIC FLOOR ALONG THE MIDDLE RECTAL VESSELSBLOOD SPREAD : BLOOD SPREAD ANAPLASTIC TUMORS IN YOUNG PRONE TO SPREAD BY BLOOD STREAM SPREAD IS MOSTLY TO LIVER, LUNG AND ADRENALSPowerPoint Presentation: Symptoms associated with RC weight loss loss of appetite night sweats fever rectal bleeding change in bowel habits obstruction abdominal pain & mass iron-deficiency anemiaPowerPoint Presentation: TNM system Primary tumor (T) Regional lymph nodes (N) Distant metastasis (M) Staging of RCPowerPoint Presentation: Staging of RC A Mucosa 80% B Into or through M. propria 50% C1 Into M. propria, + LN ! 40% C2 Through M. propria, + LN! 12% D distant metastatic spread <5% Dukes staging systemPowerPoint Presentation: Sites of metastasis Liver Lung Brain Bones Via blood Lymph nodes Abdominal wall Nerves Vessels Via lymphatics Per continuitatemINVESTIGATION : INVESTIGATION RECTAL EXAMINATION ABDOMINAL EXAMINATION PROCTOSCOPY SIGMODOSCOPY IMAGING STUDIES BARIUM ENEMA, CT SCAN, TRANS RECTAL ULTRASOUND.PowerPoint Presentation: Therapy Surgical resection the only curative treatment Likelihood of cure is greater when disease is detected at early stage Early detection and screening is of pivotal importanceTREATMENT: TREATMENT VARIOUS MODALITIES RADICAL OPERATION SPHINCTER CONSERVING OPERATION LOCAL EXCISION FULGRATION LASER PHOTOCOGULATION PALLIATIVE PROCEDURES RADIATION THERAPY ADJUENT THERAPYPowerPoint Presentation: fecal occult blood test (FOBT) chemical test for blood in a stool sample. annual screening by FOBT reduces colorectal cancer deaths by 33% Flexible sigmoidoscopy can detect about 65%–75% of polyps and 40%–65% of colorectal cancers. rectum and sigmoid colon are visually inspected Types of ScreeningPowerPoint Presentation: regular screening for all adults aged 50 years or older is recommended FOBT every year flexible sigmoidoscopy every 5 years total colon examination by colonoscopy every 10 years or by barium enema every 5–10 years Current Screening GuidelinesMALIGNANT TUMORS OF ANAL CANAL: MALIGNANT TUMORS OF ANAL CANAL SQUAMOUS CELL CARCINOMA RARELY MALIGNANT MELANOMA SCC _ CRONIC IRRITATION, POOR HYGIENE, CRONIC WOUNDS (FISTULA IN ANO),CRONIC INFECTION, RADIATION HUMAN PAPPILOMA VIRUS AND HERPES SIMPLEX VIRUS TYPE 2SITE: SITE AREA ABOVE THE DENTATE LINE SPREAD LOCAL SPREAD _ UPWORD LYMPHATIC SPREAD _INGUINAL GROUP OF NODESCLINICAL FEATURE : CLINICAL FEATURE AT ANY AGE BUT COMMONLY IN ELDER PATIENTS EARLY LESION IS SMALL, MOBILE AND POLYPOIDAL BLEEDING WITH MUCOUS DISCHARGE LARGE ULCER WITH INDURATION WITH PALPABLE MASS ANORECTAL PAINPowerPoint Presentation: CONFIRMATION BY BIOPSY TREATMENT WIDE LOCAL EXCISION IF THE LESION IS LESS THAN 2 CM DISTAL TO DENTATE LINE AND WELL DIFFERENTIATED LARGER LESIONS APR RADIOTHERAPY CHEMOTHERAPY _ 5FU, MYTOMYCIN, AND CYSPLATINSummary : Summary Pathology and staging of rectal cancer Early symptoms of rectal cancer Diagnosis and assessment of rectal cancer Various surgeries for rectal cancer. You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
5ANORECTAL CARCINOMA drvinayshahapurkar Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 49 Category: Education License: All Rights Reserved Like it (0) Dislike it (0) Added: December 05, 2011 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript ANORECTAL MALIGNENCY: ANORECTAL MALIGNENCY DR.V.V.SHAHAPURKAR PROF.DEPT. OF SURGERY DMIMSLearning objectives : Learning objectives Carcinoma of rectum is common and its symptoms are similar to those of benign diseases and , hence, patients with such symptoms must be evaluated carefullyPowerPoint Presentation: INCIDENCE- 70 % IN RECTUM AND RECTO SIGMOID REGION ONE THIRD CAN BE PALPATED DIGITITAL EXAMINATION AND 60% CAN BE VISUALISED BY SIGMOIDOSCOPY NEXT TO STOMACH CANCER IN INDIAPowerPoint Presentation: Typical sites of incidence and sympoms of colon cancerPowerPoint Presentation: Risk factors for RC Age Adenomas, Polyps Sedentary lifestyle, Diet, Obesity Family History of RC Inflammatory Bowel Disease (IBD) Hereditary Syndromes (familial adenomatous polyposis (FAP))PowerPoint Presentation: result of interplay between environmental and genetic factors Central environmental factors: diet and lifestyle 35% of all cancers are attributable to diet 50%-75% of RC in the INDIA may be preventable through dietary modifications Development of RCPowerPoint Presentation: consumption of red meat animal and saturated fat refined carbohydrates alcohol increased risk Dietary factors implicated in rectal carcinogenesisPowerPoint Presentation: dietary fiber vegetables fruits antioxidant vitamins calcium folate (B Vitamin) decreased risk Dietary factors implicated in rectal carcinogenesisPATHOLOGY: PATHOLOGY MAJORITY ADENOCARCINOMA RARE SQUAMOUS CELL CARCINOMA, MALIGNANT MELANOMA, AND LEOMYOSARCOMA.ADENOCARCINOMA : ADENOCARCINOMA WELL DIFFERENTIATED MODERATELY DIFFERENTIATED POORLY DIFFERENTIATED MACROSCOPIC - ULCERATIVE POLYPOID (CAULIFLOWER) ANNULAR (INFILTRATING)ULCERATIVE : ULCERATIVE TYPICAL MALIGNANT ULCER WITH RAISED, ROLLED OUT EVERTED EDGES AND EXCAVATED FLOOR POLYPOID _ AT AMPULLA OF THE RECTUM ANNULAR _ AT RECTOSIGMOID REGIONSPREAD : SPREAD DIRECT SPREAD _ ULCERATIVE MURAL INFIL SPREADS TO SURROUNDING FAT TRATION POLYPOID LESION _ LATE MURAL SPREAD ANNULAR CIRCUMFERENCIAL SPREAD ONCE MUSCULAR COAT PENETRATED GROWTH TO SURROUNDING FAT PERIRECTAL FASCIA (DENONVILLIER) INVOLVE IN ADVANCE CASE .LYMPHATIC SPREAD: LYMPHATIC SPREAD PARARECTAL NODES INTERMEDIATE NODES ALONG THE LOWER PART OF SUPERIOR RECTAL ARTERY AND ITS BRANCHES CENTRAL NODES AT ORIGIN OF INFERIOR MESENTRIC ARTERYPowerPoint Presentation: ABOVE THE PERITONEAL REFLECTION AND BELOW THE PERITONEAL REFLECTION SPREAD IS UPWORD LOWER DOWN LATERALLY TOWARDS PELVIC FLOOR ALONG THE MIDDLE RECTAL VESSELSBLOOD SPREAD : BLOOD SPREAD ANAPLASTIC TUMORS IN YOUNG PRONE TO SPREAD BY BLOOD STREAM SPREAD IS MOSTLY TO LIVER, LUNG AND ADRENALSPowerPoint Presentation: Symptoms associated with RC weight loss loss of appetite night sweats fever rectal bleeding change in bowel habits obstruction abdominal pain & mass iron-deficiency anemiaPowerPoint Presentation: TNM system Primary tumor (T) Regional lymph nodes (N) Distant metastasis (M) Staging of RCPowerPoint Presentation: Staging of RC A Mucosa 80% B Into or through M. propria 50% C1 Into M. propria, + LN ! 40% C2 Through M. propria, + LN! 12% D distant metastatic spread <5% Dukes staging systemPowerPoint Presentation: Sites of metastasis Liver Lung Brain Bones Via blood Lymph nodes Abdominal wall Nerves Vessels Via lymphatics Per continuitatemINVESTIGATION : INVESTIGATION RECTAL EXAMINATION ABDOMINAL EXAMINATION PROCTOSCOPY SIGMODOSCOPY IMAGING STUDIES BARIUM ENEMA, CT SCAN, TRANS RECTAL ULTRASOUND.PowerPoint Presentation: Therapy Surgical resection the only curative treatment Likelihood of cure is greater when disease is detected at early stage Early detection and screening is of pivotal importanceTREATMENT: TREATMENT VARIOUS MODALITIES RADICAL OPERATION SPHINCTER CONSERVING OPERATION LOCAL EXCISION FULGRATION LASER PHOTOCOGULATION PALLIATIVE PROCEDURES RADIATION THERAPY ADJUENT THERAPYPowerPoint Presentation: fecal occult blood test (FOBT) chemical test for blood in a stool sample. annual screening by FOBT reduces colorectal cancer deaths by 33% Flexible sigmoidoscopy can detect about 65%–75% of polyps and 40%–65% of colorectal cancers. rectum and sigmoid colon are visually inspected Types of ScreeningPowerPoint Presentation: regular screening for all adults aged 50 years or older is recommended FOBT every year flexible sigmoidoscopy every 5 years total colon examination by colonoscopy every 10 years or by barium enema every 5–10 years Current Screening GuidelinesMALIGNANT TUMORS OF ANAL CANAL: MALIGNANT TUMORS OF ANAL CANAL SQUAMOUS CELL CARCINOMA RARELY MALIGNANT MELANOMA SCC _ CRONIC IRRITATION, POOR HYGIENE, CRONIC WOUNDS (FISTULA IN ANO),CRONIC INFECTION, RADIATION HUMAN PAPPILOMA VIRUS AND HERPES SIMPLEX VIRUS TYPE 2SITE: SITE AREA ABOVE THE DENTATE LINE SPREAD LOCAL SPREAD _ UPWORD LYMPHATIC SPREAD _INGUINAL GROUP OF NODESCLINICAL FEATURE : CLINICAL FEATURE AT ANY AGE BUT COMMONLY IN ELDER PATIENTS EARLY LESION IS SMALL, MOBILE AND POLYPOIDAL BLEEDING WITH MUCOUS DISCHARGE LARGE ULCER WITH INDURATION WITH PALPABLE MASS ANORECTAL PAINPowerPoint Presentation: CONFIRMATION BY BIOPSY TREATMENT WIDE LOCAL EXCISION IF THE LESION IS LESS THAN 2 CM DISTAL TO DENTATE LINE AND WELL DIFFERENTIATED LARGER LESIONS APR RADIOTHERAPY CHEMOTHERAPY _ 5FU, MYTOMYCIN, AND CYSPLATINSummary : Summary Pathology and staging of rectal cancer Early symptoms of rectal cancer Diagnosis and assessment of rectal cancer Various surgeries for rectal cancer.