Kaplan-Step 2- Oncology – Flashcards

1. Small bowel (frequently found) 2. Appendix 3. Stomach 4. Colon 5. Bronchopulmonary tree

F. non-metastatic GI carcinoid tumors do NOT produce carcinoid syndrome b/c serotonin secreted into the portal circulation is metabolized by the liver ~ once the tumor metastasizes to the liver or other locations that drain into the systemic circulation (eg. bronchopulmonary carcinoids) will produce systemic effects (flushing & diarrhea)

F. unmetabolized serotonin causes fibrous deposits on the endocardium of heart chambers, valvular leaflets and cusps as well as the intima of the pulmonary artery and aorta in carcinoid syndrome The RIGHT heart is mostly affected b/c the lungs (just like the liver) metabolize serotonin and protect the LEFT heart. ~ the tricuspid & pulmonic valves are affected and can become either stenotic or insufficient (Left heart involvement is seen in <10% of patients with carcinoid heart disease - mostly in patients with right-to-left shunt as in patent foramen ovale or in primary bronchial carcinoid tumors)

1. Liver cancer 2. Brain cancer 3. Angiosarcoma 4. lung cancer (less common) **compound freq. used in manufacturing

PHYSICAL EXAM: 1. physical exam every 3-6mths for the first 3 years 2. physical exam every 6-12mths for years 4 &5 3. Physical exams every 12mths >5years MAMMOGRAM: (for breast-conserving surgery) --> 1 year after the initial mammogram --> at least 6mth after completion of radiation therapy NO other investigations are recommended as routine follow-up in an asymptomatic patient with no specific findings

Stage I: involvement of a single LN region or organ Stage II: Involvement of LN regions or an extralymphatic organ and LN on the SAME side of the diaphragm Stage III: Involvement of LN regions on BOTH sides of the diaphragm Stage IV: diffuse involvement of extralymphatic organs including the bone marrow