Cancer Spread and Metastasis

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Questions and Answers

What is the common route of metastasis for carcinomas?

Direct implantation

Trans-coelomic spread

Hematogenous route

Lymphatic channels (correct)

Which of the following tumours is known to metastasize late?

Follicular Thyroid carcinoma

Breast carcinoma

Melanoma

Renal Cell Carcinoma (correct)

What is the term for the formation of new blood vessels from existing ones in tumour growth?

Vascularisation

Angiogenesis (correct)

Tumour angiogenesis and stroma

Neovascularisation

What is the characteristic microscopic feature of epithelial tumours?

Acini, sheets, columns, cords, islands etc Signup and view all the answers

What is the term for the study of the shape and structure of cells in tumour diagnosis?

Histomorphology Signup and view all the answers

Which of the following is a characteristic feature of neoplastic cells?

Loss of polarity Signup and view all the answers

What is the term for the spread of tumour cells through body cavities and natural spaces?

Trans-coelomic spread Signup and view all the answers

Which of the following is an exception to the general rule of carcinoma spread through lymphatic channels?

Follicular Thyroid carcinoma Signup and view all the answers

What is the primary way in which tumor cells spread to distant locations?

Metastasis Signup and view all the answers

What is the term for the microscopic features of neoplasia?

Histomorphology Signup and view all the answers

What is the role of growth factors in tumor growth?

Promoting tumor growth Signup and view all the answers

What is the estimated global incidence of cancer in 2030?

21.4 million Signup and view all the answers

Which of the following is NOT a characteristic of tumor cells?

Normal growth rate Signup and view all the answers

What is the term for the process by which tumor cells invade and destroy surrounding tissues?

Local invasion Signup and view all the answers

What is the leading cause of cancer mortality in developing countries?

Lung cancer Signup and view all the answers

What is the relationship between the rate of tumor growth and the degree of differentiation?

Directly proportional Signup and view all the answers

What is a characteristic of malignant tumours that distinguishes them from benign tumours?

They are irregular in shape and poorly circumscribed Signup and view all the answers

How do malignant tumours spread?

Through local invasion and metastasis Signup and view all the answers

What is a feature of normal cells that is lost in cancer cells?

Dependence on neighbouring cells for growth control Signup and view all the answers

Why do cancer cells proliferate rapidly?

Because they disobey growth controlling signals Signup and view all the answers

What is a characteristic of benign tumours?

They are spherical or ovoid in shape and well-circumscribed Signup and view all the answers

What happens to normal tissues when malignant tumours invade?

They are infiltrated and destroyed Signup and view all the answers

What is a way that malignant tumours can travel to distant sites?

Through tissue spaces and permeation of lymphatics Signup and view all the answers

What is a difference between malignant and benign tumours in terms of their shape?

Malignant tumours are irregular, while benign tumours are spherical Signup and view all the answers

Study Notes

Routes of Metastasis

Lymphatic spread: common in carcinomas
Hematogenous spread: common in sarcomas
Spread along body cavities and natural spaces:
- Trans-coelomic spread
- Epithelium-lined surfaces
- Cerebrospinal fluid
- Implantation
Exceptions: Cancers like RCC, HCC, and Follicular Thyroid carcinoma can spread to distant sites by hematogenous spread

Late Metastasizing Malignancies

Renal Cell Carcinoma
Salivary gland carcinoma
Breast Carcinoma
Carcinoid tumour
Melanoma
Granular cell tumour of the ovary
Endometrial stromal sarcoma

Microscopic Features

Microscopic patterns:
- Epithelial tumours: acini, sheets, columns, cords, islands
- Mesenchymal tumours: interlacing bundles, fascicles, whorls
Histomorphology of neoplastic cells:
- Karyomegaly
- Loss of polarity
- Hyperchromatism
- Irregular nuclear margin
- Pleomorphism
- Anisonucleosis
- Increased nucleo-cytoplasmic ratio
Tumour angiogenesis:
- Stimulation of new blood vessel formation from existing ones

Historical Background

Cancer is not unique to humans, found in:
- Cnidaria (600 million years)
- Echinodermata (500 million years)
- Cephalopoda (500 million years)
- Amphibia (300 million years)
- Aves (150 million years)
Never seen in Nematoda, Tradigrada, and Rotifera

Epidemiology of Cancer

2008 global cancer incidence: 12.7 million
2008 global cancer mortality: 7.6 million (21,000 deaths per day)
2030 predicted global cancer incidence: 21.4 million
2030 predicted global cancer mortality: 13.2 million
Second leading cause of death globally (WHO)
70% of cancer mortality in developing countries
Top 5 cancers in 2019: Breast, Lung, Prostate, Colorectum, and Stomach (GLOBOCAN 2020)

Characteristics of Tumours

Rate of growth:
- Tumour cells proliferate more rapidly than normal cells
- Malignant cells grow more rapidly than benign ones
- Rate of growth dependent on degree of differentiation
Cancer phenotype and stem cells:
- Cancer cells disobey growth controlling signals and proliferate rapidly
- Cancer cells are immortal by escaping death signals
- Cancer cells lose properties of differentiation
- Cancer cells develop newer mutations
- Cancer cells overrun neighboring cells and invade locally

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Description

Learn about the different routes of cancer metastasis, including lymphatic and hematogenous spread, and understand how different types of cancer spread through the body.