Cancer locations and gene mutations

non-small cell carcinoma

• squamous cell carcinoma
• large cell carcinoma
• adenocarcinoma

EGFR, KRAS, ALK

more common that primary lung tumours

• from breast, GI and kidney

carcinoma - breast lung, others

lymphoma

melanoma

renal cell carcinoma - VHL. Causes cannonball mets on lungs

• clear cell - 75%
• papillary - 10%

Wilms' tumour (nephroblastoma) - WT1

prostatic adenoma/carcinoma - BRCA1/2

• causes bone mets with sclertotic changes

FIGO staging

HPV16&18 testing - p16 positive confirms HPV associated but can be independant

cervical intraepithelial neoplasia (CIN III)

squamous cell carcinoma

adenocarcinoma in situ

undifferentiated vulval intraepithelial neoplasia

• associated with HPV infection
• 5% progress to squamous cell carcinoma

differentiated VIN

• not associated with HPV
• greater risk to squamous cell carcinoma

squamous cell carcinoma 

• Lichen sclerosis & Paget's disease

90% of tumours - BRCA1/2

epithelial ovarian carcinoma - CA 125 marker

• adenofibroma 

germ-cell tumours

• teratoma (benign) 
• dysgerminoma (malignant) - LDH as marker
• yolk sac tumour (malignant) - a-FP as marker
• choriocarcinoma (malignant) - produces hCG

sex chord stromal

• thecoma/fibrothecoma (benign)
  • produce estradiol
  • Meig's syndrome = triad:
    1. ovarian tumour (fibroma)
    2. right sided PE
    3. ascites
• granulosa cell tumours (malignant)
  • low grade
  • produce estradiol
• Sertoli-Leydig cell tumor (malignant)
  • produce androgens

5-30% cancers

most common origin:

• colon
• stomach (Krukenberg tumour)
• breast 

invasive ductal carcinoma - BRCA1/2

•  most common cancer
• markers - HER2, ER, PR 

endometrioid adenocarcinoma

• most common cancer
• Lynch syndrome - increases colorectal cancer risk also

leiomyoma

• uterine fibroids
• most common tumour - benign 

oesophageal carcinoma

• squamous cell - HPV infection, smoking/alcohol
• adenocarcinoma - Barrett's oesophagus

gastric adenocarcinoma 

• intestinal type most common
• H. pylori infection

colon cancer

• FAP, Lynch syndrome
• adenocarcinoma 95%
• Mets cause mortality risk

hepatocellular carcinoma

• most common
• cirrhosis, Hepatitis B/C
• a-FP marker

angiosarcoma

• aggressive
• strongly associated with toxins - vinyl chloride, thorotrast

hepatocyte adenoma

• exogenous steroids

bile duct adenoma

• tiny white nodules on/in liver

secondary more common:

• lung
• breast
• colon
• pancreas

pancreatic carcinoma

• HER2, KRAS, p16, p53, DPC4, BRCA2
• most common at head - invades to duodenum
• less common at body/tail - invades to left adrenal, colon, spleen, stomach

chronic myeloid - mature cells

\(\downarrow\)

acute myeloid - immature cells

chronic lymphocytic - most common

acute lymphocytic

multiple myeloma \(\rightarrow\) vertebrae invasion

B cell lymphoma

• Non-Hodgkin's - most common
• Hodgkin's - Reed-Steinberg cells

basal cell carcinoma - most common

squamous cell carcinoma

melanoma

• BRAF mutation
• all malignant 

Bone sarcoma

• Osteosarcoma - most common
• Chondrosarcoma - cartilage
• Ewing sarcoma - a form of bone and soft tissue cancer most commonly affecting children and young adults

Soft tissue sarcomas

• Rhabdomyosarcoma - skeletal muscle
• Leiomyosarcoma - smooth muscle
• Liposarcoma - fat
• Synovial sarcoma - soft tissue around joints
• Angiosarcoma - blood and lymph vessels 
• Kaposi's sarcoma - cancer caused by HSV 8 most often seen in patients with end stage HIV - red/purple lesion on skin