Sample Pages of Tumour

Contents
Preface ix
Acknowledgements xi
1. INTRODUCTION TO ONCOLOGY................................................................. 1–10

Theory 2
Multiple Choice Questions 9
Answers with Explanations 9
AIIMS New Pattern 2019 Model Questions 10
2. PATHOGENESIS OF NEOPLASIA............................................................... 11–27

Theory 12
3. MICORBIOLOGY IN CANCERS..................................................................... 29–37

Theory 30
4. HEMATO-ONCOLOGY................................................................................... 39–68
Theory 40
5. HEAD AND NECK CANCERS (Including Oral Cancers, Secondaries Neck)........ 69–89
Theory 70
6. EAR, NOSE AND THROAT.......................................................................... 91–114

Theory 92
7. THYROID CANCERS................................................................................... 115–124
Theory 116
xiv
8. BREAST CANCERS..................................................................................... 125–148
Theory 126
9. GIT CANCERS.............................................................................................. 149–176

Theory 150
10. HEPATOBILIARY AND PANCREATIC CANCERS................................. 177–200

Theory 178
11. UROLOGY MALIGNANCIES..................................................................... 201–237

Theory 202
12. THORACIC TUMORS.................................................................................. 239–250

New SARP Series TUMOR
Theory 240
13. BRAIN TUMORS.......................................................................................... 251–259

Theory 252
14. SOFT TISSUE SARCOMA.......................................................................... 261–276
Theory 262
xv
15. SKIN TUMORS.............................................................................................. 277–304
Theory 278
16. PEDIATRIC SOLID TUMORS..................................................................... 305–200

Theory 306
17. ENDOCRINE TUMORS (EXCLUDING THYROID)................................. 317–326

Theory 318
18. GYNECOLOGICAL TUMORS..................................................................... 327–382

Theory 328
19. ORTHOPEDIC TUMORS............................................................................. 383–405

Theory 384
20. CHEMOTHERAPY DRUGS......................................................................... 407–422

Theory 408
21. RADIOTHERAPY PRINCIPLES................................................................ 423–431

Contents
Theory 424
22. AJCC 8TH EDITION: UPDATES............................................................... 433–440

Theory 434
BASICS IN ONCOLOGY
MC site of primary for bone metastasis: CA Prostate*
MC tumor metastasize to bone in females: CA Breast*
Osteolytic bone mets: Kidney Tumors**
Osteoblastic bone mets: Prostate Tumors**
MC site of primary for Brain secondary- Lungs* followed by breast
2
Latest MC cancer in males: Prostate > Lung > Colorectal (PLC)
Latest MC cancer in females: Breast > Lung > Colorectal (BLC)
Cancer deaths in males: Lung > Prostate
Cancer deaths in females: Lung > Breast
Osteoblastic secondaries in males is mostly due to Cancer Prostate*
Osteoblastic secondaries in females is mostly due to Cancer Breast*
Most effective radiosensitiser: Oxygen
Amifostine: Radioprotector*
Most sensitive phase of cell cycle to Radiation: G2 M > G2
Most resistant phase of cell cycle to radiation: End of S phase
Distant Metastasis
MC site of distant metastasis from lung Ca—Adrenals *next is Liver, Brain
MC site for distant metastasis from Breast Ca—Vertebrae
MC site for distant metastasis from Bladder Ca—Lung*
MC site for distant metastasis from Colorectal Ca—Liver*
MC site for distant metastasis from Melanoma (cutaneous)—Skin/subcutaneous tissue/Lung*
MC site for distant metastasis from Melanoma (ocular)—Liver*
MC site for distant metastasis from Prostate-Bones*
MC site for distant metastasis from Soft tissue sarcoma—Lung*
MC site for distant metastasis from Testis Ca—Lung*
MC site for distant metastasis from Thyroid Ca—Bone*, Lung*
Metastasis to lung is most commonly from—Breast Ca*
Author Punch
CA- 19-9 : Pancreatic cancer tumor marker*
CEA: Tumor marker for Colo rectal cancers,
AFP: Tumor marker for HCC*
PIVKA: Latest tumor marker for HCC*
Calcitonin: Tumor marker for follow up of medullary cancer.
GENERAL CONCEPTS IN TUMORS AND MANAGEMENT OF TUMORS

Diagnosis of Cancer
Clinical
Cytology
Histopathology
Immunology
Genetics
Radiology
Tumor markers
Treatment of Cancer
Locoregional
zz Surgery / Radiotherapy
Systemic
zz Chemotherapy
zz Hormones
zz Immunological agents 3
zz Targeted therapy
PRINCIPLES OF CANCER SURGERY

Margin negativity in three dimensions
Excision with regional lymph nodes in toto wherever applicable
Minimise tumour spillage
Excise previous scars and drain sites
RADIATION THERAPY IN CANCER

Radiation therapy (RT/RTx/(XRT) is therapy using ionising radiation
It is generally used as part of cancer treatment to control or kill malignant cells and is delivered by a linear accelerator.
Types of Radiotherapy (RT)

Teletherapy: Beams of radiation generated at far off distance and aimed at a tumor in the patient . This is the
commonly used mode of (RT)
Brachytherapy: (RT) implanted directly into tumor.
Systemic (RT): Radio nuclides targeted by some method
CONCEPTS OF RADIOBIOLOGY
Radiation dose: SI unit of absorbed radiation dose is Gray(Joule/Kg)
Fractionation: Fractionation of treatment allows recovery of normal tissues while depleting the no. of surviving
Chapter 1  Introduction to Oncology

tumor cells.
Chemoradiation
Radiation increases the cellular uptake of platinum.
Hydroxyurea preferentially kills cells in the radioresistant S phase of cell cycle
The G2/M phase of cell cycle is the most radiosensitive portion of cell cycle.
Paclitaxel sensitizes cells in the G2/M phase
Some chemotherapy drugs can recall irradiated volumes by erythema on the skin or by production of pulmonary
radiations, e.g. Adriamycin. This is referred to as radiation recall.
Radiation Types
Electromagnetic Radiations
X rays
Gamma rays
Multiple Choice Questions
1. Tumor lysis Syndrome is characterised by all 3. Prefix symbol used to describe the administration
except? (AIIMS Nov 2017) of neo-adjuvant treatment given in colorectal
a. Hyperuricemia cancer is? (FMGE Pattern 2017)
b. Hypercalcemia a. h
9
c. Hyperkalemia b. p
d. Hyperphosphatemia c. y
2. A child with cancer to monitor Tumor lysis d. z
syndrome which of the following investigations 4. Cancericidal solution is
need to be done? (JIPMER Nov 2017) (Recent Pattern 2017)
a. Urea, Creatinine, Chloride and Ca2+, K+ a. 1% cetrimide
b. Urea, Creatinine, Phosphate and Ca2+, K+ b. Phenol
c. Urea, Creatinine, Magnesium and Ca2+, K c. Formaldehyde
d. Urea, Calcium, Ammonia d. 10% saline
Answers with Explanations

1. Ans. (b) Hypercalcemia preoperative therapy, the TNM classification
[Ref: Surgery Sixer 2nd Edition Page 944] of the International Union Against Cancer and
American Joint Committee on Cancer includes a
•• Tumor lysis syndrome is characterised by Hypo-
prefix “yc,” with yc used for clinical and “yp” for
calcemia and not by Hypercalcemia**
pathologic classifications.
•• The ypTNM classification deals with the extent of
2. Ans. (b) Urea, Creatinine, Phosphate, Calcium
and potassium cancer after therapy. Therefore, ypTNM should
[Ref: surgery sixer page 944] consider only viable tumor cells and not signs
of regressed tumor tissue such as scars, fibrotic
•• Please remember Calcium is low all others are areas, fibrotic nodules, granulation tissue, or
increased mucin lakes
Chapter 1  Introduction to Oncology

3. Ans. (c) y 4. Ans. (a) 1% cetrimide
[Ref: Internet Sources] [Ref: Internet journals]
•• The use of preoperative adjuvant therapy is •• The routine use of cetrimide as a tumoricidal
becoming increasingly frequent for a number of irrigant in colorectal surgery.
tumors. •• Rectal irrigation with various agents including
•• Therefore, the pathologic classification after mercuric perchloride, povidone iodine and
preoperative therapy may not reflect the true Cetrimide has been shown to be effective in
anatomic extent of disease before treatment. reducing anastomotic recurrence following
•• To indicate that the clinical or pathologic anterior resection.
classification has been determined after •• Of these various agents, cetrimide is in routine
use in many hospitals.
Extra Mile
AJC Classification
T1: Tumor limited to antral mucosa of infrastructure without bone erosion.
T2: Tumor of superstructure with no bone destruction or in infrastructure with medial bony wall destruction
T3: Tumor invades the skin of cheek, pterygoid muscle, orbit and anterior ethmoid
102 T4: Cribriform plate, sphenoid sinus, nasopharynx skull base, pterygoid plates and posterior ethmoid involvement
is present.
Ohngren’s Line
Fig. 10: Ohngren’s Line (Imaging line)
An imaginary line drawn between medial canthus and angle of mandible.

A growth above this line – suprastructure has poor prognosis
Lederman’s Classification
Fig. 11: Lederman’s Classification
Two lines one passing through antrum floor and roof divides area into 3 parts:
zz Intrastructure
zz Mesostructure
zz Suprastructure
Suprastructure tumors are more complicated.
Other Non Coding Sequences in Human Genome
MicroRNA
Long non coding RNA
Transposons
Centromere
Telomere
16 Promoter and enhancer regions
Transposons or jumping genes
TUMOR PROGESSION
Can be explained by Galapagos finches theory
Subclones which have the capacity to overgrow other tumor cells arises from the tumor (SURVIVAL OF THE
FITTEST)
These subclones are later replaced by still malignant subclones
This feature render the tumor to become more aggressive over time – Tumor PROGRESSION
Hallmark of Malignancy
Self-sufficiency of growth signals
Insensitivity to growth inhibition
Altered cellular metabolism
Evasion of apoptosis
Limitless replicative potential
Sustained angiogenesis
Ability of invasion and metastasis
Evasion of host defenses
Genomic Instability
Hallmark of malignancy is ANAPLASIA (Lack of differentiation)
Self-Sufficiency of Growth Signals

Oncogene: Genes that promotes its own growth in an autonomous fashion
Protooncogene: Unmutated counterparts of oncogene Fig. 2: Protooncogene promotes
Aberrations in signalling pathways can lead to the development of tumors cancer
The major signalling pathways affected includes:
G protein coupled Receptor pathway, WNT signalling pathway, Notch, Hedgehog, JAK/STAT pathway, etc.
TABLE 1: Protooncogenes and their associated tumors
Category Protooncogene Associated tumor

GROWTH FACTORS
PDGF -β PDGFB Astrocytoma
Fibroblast growth factor FGF3 Osteosarcoma, Breast carcinoma, Gastric
carcinoma
TGF -α TGFA Astrocytoma
HGF HGF Hepatocellular carcinoma, thyroid
malignancies
Contd...
Category Protooncogene Associated tumor
GROWTH FACTOR RECEPTORS
ERBB1 (EGFR) Pulmonary adenocarcinoma
EGF Receptor family ERBB2 (Her2) Breast carcinoma
Receptor for Kit ligand KIT GIST, Seminoma
ALK receptor ALK Adenocarcinoma of lung,
17
neuroblastoma,
FMS like tyrosine kinase 3 FLT3 Leukemia
Receptor for neurotrophic factors RET MEN 2A, 2B
Familial medullary thyroid carcinoma
PROTEINS INVOLVED IN SIGNAL TRANSDUCTION
KRAS Carcinoma colon, lung and pancreas
HRAS Renal and urinary bladder tumors
NRAS Melanoma, hematological malignancies
GTP binding proteins GNAQ Uveal melanoma
GNAS Pituitary adenoma
JAK/STAT pathway JAK2 Myeloproliferative disorders, ALL
Non receptor tyrosine kinase ABL CML, ALL
Notch pathway NOTCH 1 Leukemia, lymphoma, carcinoma breast
NUCLEAR REGULATORY PROTEINS
Transcriptional activators C- MYC Burkitt lymphoma
N- MYC Neuroblastoma
CELL CYCLE REGULATORS
Cyclins Cyclin D1 Mantle cell lymphoma, Multiple
myeloma, Esophageal carcinoma, Breast
carcinoma
Chapter 2  Pathogenesis of Neoplasia

Cyclin dependent kinase CDK4 Glioblastoma, sarcoma, Melanoma
H igh Y ield fact

All growth factors are protooncogenes except TGF – β which is a tumor suppressor gene
Hepatocyte Growth Factor (HGF): HGF (Also called scatter factor), Receptor for HGF – MET
Extra Mile
Tumors Associated with BRAF Mutation
Papillary thyroid carcinoma
Malignant melanoma
Colonic carcinoma
Langerhan cell histiocytosis
Hairy cell leukemia
AIIMS New Pattern 2019 Model Questions
1. Match the following C. BRCA1 gene is located on chromosome 17q21
A. APC - 1. Cowden Syndrome D. BRCA 2 gene is located on chromosome 13q12.3
26 B. PTEN - 2. Gastric carcinoma a. Option A and C are false
C. E Cadherin - 3. Familial Adenomatous polyposis b. Option B and C are true
D. PTCH - 4. Pancreatic carcinoma c. Option B is false
- 5 . Peutz Jeghers syndrome d. Option A, B, C and D are true
- 6 . Basal cell carcinoma
a. A-3, B-2, C-1, D-6 Ans. (d) Option A, B, C and D are true
b. A-3, B-6, C-1, D-4 Molecular classification of breast carcinoma:
c. A-3, B-1, C-2, D-6
d. A-3, B-5, C-6, D-4 Luminal A Luminal B Her 2 Triple
positive negative
Ans. (c) A-3, B-1, C-2, D-6 ER +ve ER +ve ER -ve ER -ve
PR +/- PR +/- PR -ve PR -ve
2. Assertion: Rb gene is active in hyperphosphorylated Her 2 neu Her 2 neu Her 2 neu Her 2 neu
state -ve +ve +ve -ve
Reason: In hyperphosphorylated state, Her 2 neu
a. If both assertion and reason are true and the - ve (few
reason is the correct explanation of the Assertion cases)
b. If both assertion and reason are true but the
reason is not the correct explanation of the E.g: Tubular E.g: E.g:
Assertion carcinoma, Apocrine Medullary
c. If Assertion is true but reason is false mucinous carcinoma carcinoma
d. If Assertion is false and reason is true carcinoma Adenoid
Ans. (d) If Assertion is false and reason is true cystic
•• Rb gene is active in hypophosphorylated state
carinoma
•• Rb gene is inactive in hyperphosphorylated state
4. 30 year old female was diagnosed to have breast
•• Hypophosphorylated Rb , complexes with E2F
cancer and was under treatment. During followup,
transcription factor and inhibits the transcription
she developed a lesion in the thigh measuring
of genes required for the Synthetic (S) phase of
8x8cm. Biopsy proved it to be a high grade sarcoma.
cell cycle.
3 months later, the patient developed headache
•• Phosphorylation of Rb gene by Cyclin dependent
and vomiting. CT brain was done and was found
kinases CDK4/cyclin D, CDK6/cyclin D
to have a brain tumor. Mutation in which of the
and CDK2/Cyclin E leads to release of E2F
(Elongation factor 2), thus leading to progression following gene could have been implicated in the
of S (Synthetic) phase causation?
a. APC
3. 40 year old nulliparous lady with family history

of breast cancer presented with lump in the upper b. PTEN
outer quadrant of right breast since 5 months. c. PTCH
Histopathology was reported as Invasive ductal d. p53
carcinoma, grade II. Choose the correct options e. WT-1
amongst the following
Ans. (d) p53
A. BRCA 1 associated breast cancers are poorly The given history is in favour of Li-Fraumeni
differentiated syndrome which is due to mutation in p53 gene
B. Apocrine carcinoma is usually Her2 positive
5. Arrange the following in the sequence of Ans. (c) CADB
occurrence in the causation of colonic carcinoma? Sequential arrangement of Model for colorectal
A. Activation of RAS carcinoma through adenoma-carcinoma sequence.
B. Loss of tP53 •• Inactivation of APC gene
C. Inactivation of APC gene •• Activation of RAS
D. Loss of tumor suppressor gene on 18q Loss of tumor suppressor gene on 18q
a. BACD b. BADC •• Loss of tP53
c. CADB d. ACBD 27
6. 56 year old farmer presented with pearly white lesion with telangiectasia on the face. Gross and microscopic
picture of a malignant neoplasm is given below. Identify the syndrome associated with the shown malignant
neoplasm.
a. Gorlin syndrome
b. Gardner syndrome
c. Wilms tumor
d. Tuberous sclerosis
Ans. (a) Gorlin syndrome Chapter 2  Pathogenesis of Neoplasia

•• The given image shows basal cell carcinoma.
•• Histologically basal cell carcinoma shows peripheral palisading, retraction clefts and mucin deposition in the
stroma.
•• Gorlin syndrome is due to mutation in PTCH gene.
STAGES OF HEMATOPOIESIS
Hematopoiesis takes place in the following organs during development
Till 3rd week – Yolk sac (Mesoblastic stage)
3rd Month – Liver (Hepatic stage)
4th month – Bone marrow (Myeloid stage)
Birth – Bone marrow
40
Adult – Bones in which red marrow is present – Vertebra, ribs, skull, sternum, pelvis, proximal epiphysis of humerus
and femur
In Severe anaemia, EXTRAMEDULLARY Hematopoiesis can occur in liver and spleen.
First definitive Hematopoiesis – Mesoderm of intraembryonic aorta, gonad and mesonephros(AGM)
Hematopoiesis At A Glance
Fig. 1: Hematopoiesis at a glance

STRUCTURE OF A LYMPH NODE
41
Fig. 2: Structure of a lymph node
Must Know
Most Common
Most common haematological malignancy in children ALL
Most common leukemia in adults CLL
Most common site of extranodal lymphoma: Stomach
Most common site of extranodal lymphoma in HIV patients: Central nervous system (CNS)
Origin of Lymphoma
Burkitt lymphoma, Follicular lymphoma: Germinal center B cell
Mantle cell lymphoma: Naive B cell
Hairy cell leukemia, extranodal marginal zone lymphoma: Memory B cell
IHC Markers
CD 3: Pan T cell marker
CD 19: Pan B cell marker
Chapter 4  Hemato-oncology

CD 16, CD 56: NK cell marker
CD13, 33: Marker for macrophages
CD 34: Hematopoeitic stem cell marker
CD 68: Histiocytic marker
CD 38, CD138: Plasma cell marker
Translocations
Burkitt lymphoma: t(8:14)
Follicular lymphoma: t(14:18)
Mantle zone lymphoma: t(11:14)
Marginal zone lymphoma: t(11:18)
Special Stains
Lymphoblasts: PAS and Tdt
Myeloblasts: MPO, Sudan black
TRAP: Hairy cell leukemia, Splenic marginal zone lymphoma
L atest U pdate
Macrophage/Dendritic Cell Neoplasm
Includes
Langerhans-related histiocytosis
Cutaneous and mucocutaneous histiocytosis
59
Mallignant histiocytoses
Rosai-Dorfman disease
Hemophagocytic lymphohistiocytosis and macrophage activation syndrome
Hemophagocytic Lymphohistiocytosis and Macrophage Activation Syndrome

Life threatening disease due to dysregulation of T cells.
There is increased cytokines, leading to macrophage hyperplasia and increased phagocytosis
Clinical Features
Fever, hepatosplenomegaly
Lymphadenopathy, rashes
Neurological features
Hypertriglyceridemia, increased ferritin
Coagulation abnormalities
Diagnostic Criteria
Fever >35deg for more than 7 days
Splenomegaly
Cytopenia- Hb<9g/dl, PLT<100000cells/microl
Increased triglycerides >2nmol/L, Hypofibrinogenemia<150mg/dl.
Haemophagocytosis in bone marrow/spleen/lymph node.
zz Decreased/ absent NK activity
zz S. Ferritin > 500microg/L
zz Soluble CD 25> 2400 U/ml
5 major/ 4 major +A/ 4 major +A&B
Langerhans Cell Histiocytosis
Langerhans cells have vesicular nuclei with grooves, and abundant vacuolated cytoplasm
Types
1. Multifocal multisystem Langerhans cell histiocytosis (Letterer Siwe disease):
zz Usually affects adults
zz Presents as seborrhoeic eruptions
2. Unifocal and multifocal unisystem Langerhans cell histiocytosis (Eosinophilic granuloma):
zz Unifocal lesions affects older children or adults
zz Multifocal unisystem affects young children
Must Know
Hand Schuller Christian Triad
Triad of:
Calvarial bone defects
Triad of
Diabetes insipidus Exophthalmos

VISUAL TREAT
1. Faggot cell: myeloblast with multiple auer rod 4. Flower cells – in adult t cell leukemia
61
2.
Ringed sideroblasts: highlighted by prussian 5. Sezary cell – in sezary syndrome
blue stain
3. Chronic myeloid leukemia 6. Multiple myeloma

7. Mott cell 9. Hairy cell leukemia
62
8. CLL 10. Leucoerythroblastic blood picture

Most common metastatic sites of prostate carcinoma are lymph nodes & bones
Lymphatic metastasis occurs most commonly to → obturator lymph nodes
Most common bony metastasis occurs in (in decreasing order)
zz Lumbar spine (most common)
zz Proximal femur
zz Pelvis
zz Thoracic spine
210 zz Ribs
Tumor Markers in CA Prostate

Serum acid phosphatase is a tumor marker of prostate Ca.
But now serum acid phosphatase assay has been superseded by PSA assay (prostate specific antigen)
Recent Advances
Prostate specific antigen
It is a glycoprotein produced only in the prostatic cells (both benign & malignant). It facilitates liquefaction of
semen.
It is neither sensitive nor specific for early prostate carcinoma, nevertheless it gives some help in making a diagnosis
zz Normal serum level  less than 4ng/ml.
zz Men aged 50-69 years: Level > 3-4 ng/ml; Advised Biopsy**
zz Localised cancers will have PSA < 10-15 ng/ml
zz Metastatic cancer will have PSA level > 30 ng/ ml
Since PSA is not specific for Cancer- PSA velocity & PSA density are used to detect prostate cancer**
Staging of prostate cancer

Tis → Carcinoma in situ
T1 → These are incidentally found tumors in a clinically benign gland after TURP
zz T1a- <5% tumor in the resected specimen
zz T1b- >5% tumor in resected specimen
zz T1c- Detected due to elevated PSA level
T2 → Tumor palpable by DRE or visible by TRUS, confined to capsule*
zz T2a- Tumor confined to one lobe
zz T2b- Tumor involving both lobe
T3 → Extra capsular extension with or without seminal vesicle involvement
T4 → Tumor directly extends into bladder neck, sphincter, rectum, pelvic side walls etc.
zz T1&T2 are early disease
zz T3&T4 are advanced disease
Fig. 5: Staging of prostate cancer

ANATOMY OF SKIN
The skin is divided into two main layers:
Surface epithelium (epidermis)
Dermis
TABLE 1: Structural or organization of skin
278 Epidermis Dermis
Keratinized stratified squamous epithelium contains following layers: Made up of two layers:
• Stratum Basale (deepest layer) • Superficial papillary
• Stratum Spinosum (Malpighian layer, Prickle cell layer) • Deep reticular layer
• Stratum Granulosum
• Stratum Lucidum
• Stratum corneum (Superficial layer)
Melanocytes are found in the junction between Stratum Basal layer and Dermis
Dermis is relatively avascular but contains tissue macrophages and mast cells.
Melanin is transferred to the surrounding basal cells through dendritic process
No of Melanocytes/unit area is same in all races
Fig. 1: Layers of skin
ACQUIRED MELANOCYTIC NEVI

It is classified based on location of Nevus:
Junctional: Between Epidermis (Stratum Basale and Dermis junction)
Compound: Between Epidermis and partly into dermis

Dermal: seen in the dermis itself.
Junctional Nevi is common in Children and has malignant potential in adult.
ETIOLOGY OF SKIN CANCERS

Actinic Damage: (SCC > BCC)
Major Carcinogenic factor
90% if skin malignancies in sun exposed areas
People at risk- Blue eyed, Fair skin, Blond and red hair
Ultraviolet B in sunlight is highly carcinogenic.
Ultraviolet light C in Arc welders is also carcinogenic.

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Contents

1. INTRODUCTION TO ONCOLOGY................................................................. 1–10

2. PATHOGENESIS OF NEOPLASIA............................................................... 11–27

3. MICORBIOLOGY IN CANCERS..................................................................... 29–37

6. EAR, NOSE AND THROAT.......................................................................... 91–114

9. GIT CANCERS.............................................................................................. 149–176

10. HEPATOBILIARY AND PANCREATIC CANCERS................................. 177–200

11. UROLOGY MALIGNANCIES..................................................................... 201–237

12. THORACIC TUMORS.................................................................................. 239–250

13. BRAIN TUMORS.......................................................................................... 251–259

16. PEDIATRIC SOLID TUMORS..................................................................... 305–200

17. ENDOCRINE TUMORS (EXCLUDING THYROID)................................. 317–326

18. GYNECOLOGICAL TUMORS..................................................................... 327–382

19. ORTHOPEDIC TUMORS............................................................................. 383–405

20. CHEMOTHERAPY DRUGS......................................................................... 407–422

21. RADIOTHERAPY PRINCIPLES................................................................ 423–431

22. AJCC 8TH EDITION: UPDATES............................................................... 433–440

GENERAL CONCEPTS IN TUMORS AND MANAGEMENT OF TUMORS

PRINCIPLES OF CANCER SURGERY

RADIATION THERAPY IN CANCER

Types of Radiotherapy (RT)

Chapter 1  Introduction to Oncology

Answers with Explanations

Chapter 1  Introduction to Oncology

Fig. 10: Ohngren’s Line (Imaging line)

 An imaginary line drawn between medial canthus and angle of mandible.

Fig. 11: Lederman’s Classification

Self-Sufficiency of Growth Signals

Category Protooncogene Associated tumor

Chapter 2  Pathogenesis of Neoplasia

H igh Y ield fact

3. 40 year old nulliparous lady with family history

Ans. (a) Gorlin syndrome Chapter 2  Pathogenesis of Neoplasia

Fig. 1: Hematopoiesis at a glance

Fig. 2: Structure of a lymph node

Hemophagocytic Lymphohistiocytosis and Macrophage Activation Syndrome

Diabetes insipidus Exophthalmos

8. CLL 10. Leucoerythroblastic blood picture

Tumor Markers in CA Prostate

Staging of prostate cancer

Fig. 5: Staging of prostate cancer

Fig. 1: Layers of skin

ACQUIRED MELANOCYTIC NEVI

 Compound: Between Epidermis and partly into dermis

ETIOLOGY OF SKIN CANCERS

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An imaginary line drawn between medial canthus and angle of mandible.

Compound: Between Epidermis and partly into dermis