4: Uterine cancer

Question 1

What are polyps?

Answer 1

Abnormal outgrowths of tissue

Question 2

Which type of polyps commonly appear around the time of menopause?

Answer 2

Endometrial polyp

Question 3

Which symptom can endometrial polyps cause?

Answer 3

Bleeding

abnormal uterine bleeding

Question 4

Which contraceptive can be fitted in menopausal women to control abnormal bleeding?

Answer 4

IUS

Mirena coil, secretes progesterone

Question 5

Most cases of endometrial hyperplasia are idiopathic.

Which hormone can cause it?

Answer 5

Oestrogen

Question 6

Which other structures, found in the endometrium, are affected by hyperplasia as seen during the menopause?

Answer 6

Glands

Dilate

Question 7

What are the three grades of endometrial hyperplasia?

Answer 7

Simple

Complex

Atypical (suggestive of neoplasia)

Question 8

Which type of endometrial hyperplasia has a high risk of progressing to malignancy>

How is it managed?

Answer 8

Atypical hyperplasia

Hysterectomy

Question 9

What is malignant endometrial cancer called?

Answer 9

Endometrial carcinoma

Question 10

What is the typical age of a woman presenting with endometrial carcinoma?

Answer 10

50 - 60 years old

Question 11

Which syndromes predispose a woman to endometrial carcinoma?

Answer 11

Polycystic ovarian syndrome

Lynch syndrome (HNPCC)

Question 12

Which type of hyperplasia is a precursor to endometrial carcinoma?

Answer 12

Complex / atypical hyperplasia

Question 13

Most endometrial carcinomas are ____ in nature.

Answer 13

glandular

so adenocarcinomas

Question 14

What is the presentation of an endometrial carcinoma?

Answer 14

Post-menopausal bleeding

which is abnormal

Question 15

What is the direct cause of the most common form of endometrial carcinoma?

Answer 15

Unopposed oestrogen in menopause, malprescribed HRT

Question 16

Type (I / II) endometrial tumours are the most common.

Answer 16

Type I - endometroid; assoc. unopposed oestrogen; 80% of cancers

Question 17

Which lifestyle factor is majorly associated with endometrial and breast cancers?

Why?

Answer 17

Obesity

Increased oestrogen production (adipose tissue produces aromatase, which converts androgen to oestrogen in granulosa cells)

Question 18

What management for endometrial cancer cannot be performed on women with a high BMI?

Answer 18

Hysterectomy

due to surgical risk factors

Question 19

What is Lynch syndrome also known as?

Answer 19

HNPCC

Hereditary non-polyposis colorectal cancer

Question 20

Which GI syndrome is linked with endometrial cancer?

Answer 20

Lynch syndrome / HNPCC

Question 21

Which genetic cancer syndrome is associated with Type II endometrial cancer?

Answer 21

Li Fraumeni syndrome (TP53 mutation)

Question 22

(Type I / Type II) endometrial cancer is more aggressive.

Answer 22

Type II endometrial cancer

as it’s associated with a genetic cancer syndrome and goes for the peritoneum

Question 23

The deeper into the uterine wall a tumour spreads, the more likely it is to what?

Answer 23

Invade blood vessels or lymphatics

Question 24

Where specifically in the peritoneal cavity do Type II endometrial cancers tend to end up?

Answer 24

Rectouterine pouch (of Douglas)

Question 25

Apart from **endometroid** (Type I) and **serous** (Type II) tumours, what other tumours can be found in the endometrium?

Answer 25

**Endometrial stromal tumour** **Carcinosarcoma** and others which really aren't worth learning

Question 26

Which **tumours** can arise in the **myometrium?**

Answer 26

**Leiomyo(sarcomas)**

Question 27

**Uterine leiomyomas** are also known as **\_\_\_.**

Answer 27

**fibroids** lots of people have these

Question 28

What is a **malignant** form of **uterine fibroids**? Where do they arise?

Answer 28

**Leiomyosarcoma** **Myometrium**

Question 29

What is **HNPCC** also known as?

Answer 29

**Lynch syndrome**

Question 30

Which **genetic cancer syndromes** increases a woman's likelihood of developing **endometrial carcinoma?**

Answer 30

**Lynch syndrome** / **HNPCC** **Li Fraumeni syndrome** (TP53 mutation) **Cowden syndrome** (PTEN mutation)