Types of TumorsTypes of Tumors
BenignBenign MalignantMalignant
•CarcinomaCarcinoma
•SarcomaSarcoma
TeratomaTeratoma HamartomaHamartoma
Dermoid Cyst
AngioMyoLipoma
BenignBenign EncapsulatedEncapsulated No invasionNo invasion No metastasisNo metastasis
MalignantMalignant Non encapsulatedNon encapsulated Usually invadeUsually invade MetastasisMetastasis
Benign vs Malignant Benign vs Malignant
What are the treatment implicationsWhat are the treatment implications
Local excision for benign tumors and radical excision for malignantLocal excision for benign tumors and radical excision for malignant
Characteristics of malignant cellsCharacteristics of malignant cells
Uncontrolled growth and loss of contact Uncontrolled growth and loss of contact phenomenan are the main characteristics of phenomenan are the main characteristics of
malignant cellsmalignant cells
Tumor Grading & DifferentiationTumor Grading & Differentiation
GradingGrading: Describes the histologic characteristics of : Describes the histologic characteristics of cancer cells mainly talk about cell layers.cancer cells mainly talk about cell layers.e.g.e.g. grade I, II, III.grade I, II, III.
DifferentiationDifferentiation: Describes the characteristics of : Describes the characteristics of cancer cells in reference to their resemblance to cancer cells in reference to their resemblance to the cell of origin.the cell of origin.e.g.e.g. well differentiated well differentiated
moderately differentiatedmoderately differentiated poorly differentiatedpoorly differentiated anaplastic. anaplastic.
Both describe the histological features of the tumorBoth describe the histological features of the tumor
Tumor Grading & DifferentiationTumor Grading & Differentiation
Tumor grading & tumor differentiation both describe the Tumor grading & tumor differentiation both describe the histological features of the tumor and not the macroscopic histological features of the tumor and not the macroscopic
features , invasion or metastasisfeatures , invasion or metastasis
Spread of Malignant TumorSpread of Malignant Tumor
Local invasion : Local invasion : •within the organwithin the organ
•adjacent organsadjacent organs
Metastasis :Metastasis :•Lymphatic : Regional & Lymphatic : Regional &
distant lymph nodes.distant lymph nodes.
•Haematogenous e.g. liver, Haematogenous e.g. liver, lung, bones.lung, bones.
•Transcoelomic e.g Transcoelomic e.g peritoneal & pleural cavity.peritoneal & pleural cavity.
• Implantation e.g. needle Implantation e.g. needle tracks, wounds. tracks, wounds.
STAGING OF MALIGNANT TUMORSSTAGING OF MALIGNANT TUMORS
Staging describes the primary tumor, its relation Staging describes the primary tumor, its relation with the organ of origin ,adjacent and distant organswith the organ of origin ,adjacent and distant organs
Classical:Classical: e.g. e.g. stage stage I, II, III, IVI, II, III, IVTNMTNM:e.g:e.gT1, No, MoT1, No, MoT – T – TumorTumor : : T1,2,3, TT1,2,3, Tisis, T, Taa, T, TbbN – N – NodeNode : : N0, 1, 2, 3N0, 1, 2, 3M – M – MetastasisMetastasis::M0,1,2,3M0,1,2,3
Types of Tumor StagingTypes of Tumor Staging
Why Do We Stage Malignant Tumors?Why Do We Stage Malignant Tumors?
To decide the treatmentTo decide the treatment To plan the treatmentTo plan the treatment To assess the prognosisTo assess the prognosis
Whenever you deal with malignant Whenever you deal with malignant tumor, always remember that tumor, always remember that there is primary tumor & there there is primary tumor & there
may be secondaries. may be secondaries.
Presentation of Malignant TumorsPresentation of Malignant Tumors
AsymptomaticAsymptomatic Symptoms related to the primarySymptoms related to the primary Symptoms related to the secondariesSymptoms related to the secondaries Incidental findingIncidental finding Weight loss and Cachaxia are late Weight loss and Cachaxia are late
manifestations of most malignant manifestations of most malignant
tumors except GI and Lung cancertumors except GI and Lung cancer
Investigation of Malignant TumorsInvestigation of Malignant Tumors
Investigate for the primaryInvestigate for the primary• Depends on the siteDepends on the site
• Define the histologyDefine the histology
• Define the local extensionDefine the local extension
Investigate for the secondariesInvestigate for the secondaries• Look for metastasisLook for metastasis
• Usually liver, lung and bonesUsually liver, lung and bones
Both will define the diagnosis & stageBoth will define the diagnosis & stage
How we obtain material for histologyHow we obtain material for histology
CytologyCytology : morphology of individual cells. : morphology of individual cells.• Exfoliative (urine,sputum,….)Exfoliative (urine,sputum,….)
• Fluid aspiration (ascitic fluid,pleural fluid)Fluid aspiration (ascitic fluid,pleural fluid)
• Fine needle aspiration (FNA)Fine needle aspiration (FNA)
Biopsy Biopsy : histological (tissue) : histological (tissue) characteristicscharacteristics• Incisional biopsy (open, needle, forceps..)Incisional biopsy (open, needle, forceps..)
• Excisional biopsy Excisional biopsy
Tumor MarkersTumor Markers
Substances which if present in the blood Substances which if present in the blood or tissues may indicate malignancy.or tissues may indicate malignancy.
The concept is very importantThe concept is very important There are many tumor markersThere are many tumor markers Most are non-specificMost are non-specific Important in diagnosisImportant in diagnosis Important for screeningImportant for screening Important in follow upImportant in follow up
Hormones & CancerHormones & Cancer
Hormones related to tumor growth:Hormones related to tumor growth:
• Usually sex hormones (testosterone,estrogen)Usually sex hormones (testosterone,estrogen)
• They may have a relation to tumor growthThey may have a relation to tumor growth
• Hormone receptorsHormone receptors
• The concept can be used in treatmentThe concept can be used in treatment
Hormones may be produced by tumors:Hormones may be produced by tumors:
• Originally hormone producing organ e.g. adrenalsOriginally hormone producing organ e.g. adrenals
• Originally non hormone producing organ e.g. lungOriginally non hormone producing organ e.g. lung