adenocarcinoma

Practice targeted AMC-style multiple-choice questions on adenocarcinoma.

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A 58-year-old male presents with fatigue and microcytic anemia. He denies overt bleeding but reports occasional dark stools. Colonoscopy reveals the image shown. Biopsies confirm adenocarcinoma. What is the MOST appropriate next investigation to stage the cancer?

A. Carcinoembryonic antigen (CEA) level

B. Endoscopic ultrasound

C. MRI of the abdomen and pelvis

D. CT scan of the chest, abdomen, and pelvis

E. PET-CT scan

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Hepatic metastases from a gastric mixed adenoneuroendocrine carcinoma (MANEC).

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A 68-year-old male presents with dysphagia and weight loss. Gastroscopy and biopsy confirm gastric adenocarcinoma. Staging CT imaging is shown. His ECOG performance status is 1. Considering the clinical presentation and the findings demonstrated in the provided images, what is the most appropriate initial management strategy for this patient?

A. Proceed with total gastrectomy and D2 lymphadenectomy

B. Refer for liver transplantation assessment

C. Plan palliative radiotherapy to the gastric primary

D. Initiate systemic chemotherapy

E. Consider transarterial chemoembolisation for hepatic lesions

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A 65-year-old male presents with fatigue and occult blood in stool. Colonoscopy reveals the lesion shown. Biopsy confirms adenocarcinoma. What is the MOST appropriate next investigation to determine disease stage?

A. MRI of abdomen

B. CEA level

C. PET scan

D. CT scan of abdomen and pelvis

E. Endoscopic ultrasound

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A 58-year-old male presents with a 3-month history of dyspepsia, early satiety, and unintentional weight loss. Upper endoscopy revealed a large, ulcerated mass in the gastric antrum. Biopsy confirmed adenocarcinoma. Staging investigations were performed, including the provided imaging. His ECOG performance status is 1. Blood tests show mild anaemia and normal liver function tests. Given the clinical presentation and the findings on the provided imaging, which of the following is the most appropriate primary goal of management for this patient?

A. Curative surgical resection of the primary gastric tumour

B. Radiation therapy to the gastric mass

C. Palliation of symptoms and improvement of quality of life

D. Neoadjuvant chemotherapy followed by reassessment for surgery

E. Liver transplantation

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A 65-year-old male with recently diagnosed gastric mixed adenoneuroendocrine carcinoma presents with unintentional weight loss. Endoscopy confirmed the diagnosis. Staging imaging is provided. His ECOG performance status is 1. Considering the extent of disease demonstrated, which of the following represents the most appropriate initial therapeutic approach?

A. Gastrectomy with D2 lymphadenectomy

B. Observation with regular imaging surveillance

C. Palliative radiotherapy to the gastric primary

D. Liver resection of dominant lesions

E. Systemic chemotherapy or targeted therapy

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A 72-year-old male presents with a 4-month history of increasing constipation and occasional streaks of blood on stool. He denies significant weight loss. Physical exam is unremarkable. A colonoscopy was performed, and the image is shown. Biopsies are taken from the lesion. Assuming the biopsy confirms adenocarcinoma, what is the MOST appropriate initial investigation to guide further management?

A. Referral for neoadjuvant chemotherapy

B. CT scan of chest, abdomen, and pelvis

C. Repeat colonoscopy in 3 months

D. PET scan for distant metastases

E. Endoscopic ultrasound for local staging

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A 65-year-old male presents with a 3-month history of unintentional weight loss and epigastric discomfort. Endoscopy revealed a gastric mass, and biopsy confirmed a mixed adenoneuroendocrine carcinoma. Staging imaging is shown. His ECOG performance status is 1. Considering the clinical presentation and the findings demonstrated in the provided images, what is the most appropriate initial management strategy for this patient?

A. Refer for surgical assessment for hepatic metastasectomy

B. Evaluate for potential liver transplantation

C. Plan for palliative external beam radiotherapy to the liver

D. Initiate systemic chemotherapy targeting the adenocarcinoma component

E. Commence treatment with a long-acting somatostatin analogue

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adenocarcinoma

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