Gastrointestinal (GI) Adenocarcinoma
Adenocarcinoma is the most common histological subtype of cancer arising in the GI tract, originating from glandular epithelial cells. Common sites include the stomach, esophagus, colon, and rectum.
Key Paraneoplastic Syndromes
GI adenocarcinomas are frequently associated with specific dermatological paraneoplastic syndromes that serve as important clinical clues:
- Acanthosis Nigricans: Specifically the “malignant” form; characterized by rapid onset, extensive distribution (including palms and mucous membranes), and weight loss.
- Leser-Trélat Sign: Sudden, explosive onset of multiple seborrheic keratoses.
Diagnostic & Clinical Considerations
| Feature | Details |
|---|---|
| Risk Factors | H. pylori (stomach), GERD/Barrett’s esophagus (esophagus), IBD, adenomatous polyps (colon). |
| Workup | Endoscopy/Colonoscopy with biopsy (gold standard); CT/PET for staging. |
High-Yield Exam Pearl:
- Virchow’s Node: Left supraclavicular lymphadenopathy, which may be the first sign of abdominal (gastric) malignancy.
- Krukenberg Tumor: Bilateral ovarian metastasis from a primary gastric adenocarcinoma (signet ring cell histology is common).