Clinical Features Of Neoplasia

Afza.Malik GDA

Clinical Features of Neoplasm

Clinical Features Of Neoplasia

 Clinical Features Of Neoplasia, Effects according to tumor location, Hormone production,Clogging, Irritation of serous membrane, Tine destruction.

1) Effects according to tumor location:

    Any tumor, benign or malignant may cause morbidity and mortality. Location of the tumor is of critical importance in both benign and malignant tumors eg A small pituitary adenoma (benign) can compress and destroy surrounding normal gland and give rise to hypopituitarism a small carcinoma within common bile duct (malignant) may induce fatal biliary tract obstruction .

2) Hormone production:

    Hormone production is increased in both benign (mostly) and malignant tumors arising in endocrine glands eg

    Tumors of pancreas produce increased causing amount of insulin hyperinsulinism. Tumors of adrenal cortex excessive corticosteroids

3. Clogging:

    It may be caused in a hollow viscus by tumor. in the lumen or pressing on the wall from outside eg Intestinal obstruction.

Biliary tract causing obstructive jaundice.

Urinary tract causing hydronephrosis. Bronchus-pulmonary collapse.

Portal vein ascites and varices.

4) Irritation of serous membrane 

    Deposition of tumor on serous membrane results in the form of inflammatory exudate.

5 Tine destruction: 

    Progressive destruction of time may produce a lot of function perforation or hemorrhage.

6 Infection may superimpose the ulcerated

7) Fever: Certain to produce fever directly and some indirectly due to infection

8) Anemia:

    It may be due to prolonged malnutrition. recurrent blood loss, and long-lasting infection producing marrow depression

9) Malignant cachexia: 

    The progressive weakness and lows of weight in the presence of malignant tumor is called malignant cachexia. It may be induced by the toxin produced by the tumor or by malnutrition, hemorrhage, ulceration, pain, insomnia and bacterial infection.

10) Paraneoplastic syndromes: 

    This is a collective term for disorders arising from metabolic effects of cancer on the tissues remote from the tumor eg endocrine, hematologic or neuromuscular disorders, OR The symptom complexes other than cachexia that appear in patients with cancer and that cannot be readily explained either by: Local or distant spread of tumor or by:

    Elaboration of hormones indigenous to the tissue of origin of the tumor, are referred to paraneoplastic syndromes ( ie there seems no relation between cancer and these symptoms)

Diagnosis Of Tumor (Investigations)

1) Screening:

The tests performed on asymptomatic individual to detect tumor in very early stage is called screening. Unfortunately screening methods do not exist for most types of cancers. Following are the screening tests that can detect the tumor in early stage.

Cervical smear: 

Annual cervical smears in all sexually active women is recommended. Dysplastic epithelium can be detected and treated to prevent development of cervical cancer.


Self-examination of breasts monthly to detect small lump is recommended. Mammography to detect pre-clinical breast cancer is suggested every 2 or 3 years.


People aged 50 and above are suggested to undergo sigmoidoscopy to detect early colon cancer or pre-cancerous adenomas of colon and rectum.

2) Cytological examination:

Cytological examination of cell is a useful and accurate method of diagnosing cancer. Samples for cytological examination may be obtained by a variety of techniques such as:

Exfoliated cells may be identified in samples of sputum, urine, CSF and body fluids. Malignant cells may be found in blood and bone marrow

Brushing or scraping of epithelium or of a lesion that has been visualized by endoscopy may be performed to obtain cells for examination

Fine-needle aspiration

3) Histological examination:

    This is the definitive method of establishing the diagnosis of a neoplasm. The test is based on examination of the entire neoplasm removed at surgery (excisional biopsy) or incisional biopsy or with a large bore cutting needle.

    Histologic examination reveals benign or malignant type of neoplasm, grade of malignancy, and degree of invasion.

4) Serological examination (tumor markers)
5) Radiographic examination:

    Xays , CT and MRI scans are helpful in the diagnosis of tumors. As a general rule, radiographic findings suggestive of cancer must be confirmed by either cytological or histological examination.


Surgery Radiation therapy.

Chemotherapy (anti-cancer drugs).

Radiosensitivity of tumors

Radiotherapy is an important mode of therapy as a curative and palliative treatment. Tumors differ widely in their reaction to radiotherapy.

Radio sensitivity of tumors depend on:

Degree of mitotic activity:

    Therefore rapidly dividing (labile) cells more respond to radiotherapy eg tumors of bone marrow, intestinal epithelium, and gonads. Slow dividing (stable) cells respond less as compared to labile cells while the non-dividing (permanent) cells of neurons are radioresistant).

Degree of differentiation: Undifferentiated tumors more respond than well differentiated.

Hormone dependence of tumors

Induction of tumor by hormones

1) High estrogen level

2) Anabolic steroids

3) Endometrial carcinoma Breast carcinoma Liver cell carcinoma

    Hormonal dependent tumors Many tumors that are not caused by hormones are dependent on hormones for optimal growth. The cells of such tumors have receptors on their cell membrane for hormonal binding. When the tumor is deprived of the hormone. Its growth becomes slow.

    Prostate cancer This cancer is almost always dependent on androgen. Removal of both tests or the administration of estrogen frequently results in dramatic - though temporary - regression of prostate cancer.

    Breast cancer This cancer is frequently dependent on estrogen and less frequently on progesterone. Hormone dependence correlates strongly with the presence of estrogen and progesterone receptors on the cell membrane.

Thyroid cancer

    They are dependent on thyroid stimulating hormone (TSH). Administration of thyroid hormone suppresses TSH secretion and therefore regresses thyroid cancer.

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