4: Uterine cancer Flashcards
What are polyps?
Abnormal outgrowths of tissue
Which type of polyps commonly appear around the time of menopause?
Endometrial polyp
Which symptom can endometrial polyps cause?
Bleeding
abnormal uterine bleeding
Which contraceptive can be fitted in menopausal women to control abnormal bleeding?
IUS
Mirena coil, secretes progesterone
Most cases of endometrial hyperplasia are idiopathic.
Which hormone can cause it?
Oestrogen
Which other structures, found in the endometrium, are affected by hyperplasia as seen during the menopause?
Glands
Dilate
What are the three grades of endometrial hyperplasia?
Simple
Complex
Atypical (suggestive of neoplasia)
Which type of endometrial hyperplasia has a high risk of progressing to malignancy>
How is it managed?
Atypical hyperplasia
Hysterectomy
What is malignant endometrial cancer called?
Endometrial carcinoma
What is the typical age of a woman presenting with endometrial carcinoma?
50 - 60 years old
Which syndromes predispose a woman to endometrial carcinoma?
Polycystic ovarian syndrome
Lynch syndrome (HNPCC)
Which type of hyperplasia is a precursor to endometrial carcinoma?
Complex / atypical hyperplasia
Most endometrial carcinomas are ____ in nature.
glandular
so adenocarcinomas
What is the presentation of an endometrial carcinoma?
Post-menopausal bleeding
which is abnormal
What is the direct cause of the most common form of endometrial carcinoma?
Unopposed oestrogen in menopause, malprescribed HRT
Type (I / II) endometrial tumours are the most common.
Type I - endometroid; assoc. unopposed oestrogen; 80% of cancers
Which lifestyle factor is majorly associated with endometrial and breast cancers?
Why?
Obesity
Increased oestrogen production (adipose tissue produces aromatase, which converts androgen to oestrogen in granulosa cells)
What management for endometrial cancer cannot be performed on women with a high BMI?
Hysterectomy
due to surgical risk factors
What is Lynch syndrome also known as?
HNPCC
Hereditary non-polyposis colorectal cancer
Which GI syndrome is linked with endometrial cancer?
Lynch syndrome / HNPCC
Which genetic cancer syndrome is associated with Type II endometrial cancer?
Li Fraumeni syndrome (TP53 mutation)
(Type I / Type II) endometrial cancer is more aggressive.
Type II endometrial cancer
as it’s associated with a genetic cancer syndrome and goes for the peritoneum
The deeper into the uterine wall a tumour spreads, the more likely it is to what?
Invade blood vessels or lymphatics
Where specifically in the peritoneal cavity do Type II endometrial cancers tend to end up?
Rectouterine pouch (of Douglas)
