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Constrictive Pericarditis — RACP Adult Medicine MCQ

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HardCardiologyConstrictive PericarditisRACP Adult Medicine

Endoscopic resection of a Barrett nodule unexpectedly shows adenocarcinoma invading the submucosa with lymphovascular invasion, despite clear lateral margins. What is the next management step?

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Correct answer: B — Refer for oesophageal cancer MDT staging and surgical assessment

Explanation lettering: E = shown as A · A = shown as B · D = shown as C · C = shown as D · B = shown as E

A is correct. Submucosal invasion with lymphovascular invasion confers clinically important nodal risk and exceeds routine endoscopic eradication therapy; cancer MDT staging and surgical assessment are required. B and E cannot treat nodal disease. C does not remove nodal risk. D grossly under-treats invasive cancer.

Reference: Cancer Council Australia, Barrett oesophagus clinical guidelines: https://www.cancer.org.au/clinical-guidelines/oesophageal-cancer/barretts-oesophagus