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Repro > Cancer > Flashcards

Cancer Flashcards

1
Q

Where can reproductive tract cancers occur in women?

A
  • vulva
  • cervix
  • endometrium
  • myometrium
  • ovaries
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2
Q

What type of cancer are vulval tumours and how common are they?

A

Quite uncommon

Squamous cell carcinoma

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3
Q

What is the most common cause of vulval tumours in pre menopausal and post menopausal women?

A

pre: HPV (peak incidence in 60s)
post: long standing inflammation and hyperplastic conditions such as lichen sclerosis and squamous hyperplasia

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4
Q

What is vulvar intraepithelial neoplasia?

A

Atypical squamous cells within the epidermis (no invasion)- theyre a precursors to squamous cell carcinomas. They look like raised legions, somtimes hyper or hypopigmented and can be associated with burning, itching, painful sex ect

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5
Q

Where do vulval squamous cell carcinomas spread to?

A

Inguinal, pelvic, illiac and paraaortic nodes.

Also to lung and liver.

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6
Q

How are vulval tumours treated?

A

excision and removal of lymph nodes

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7
Q

What is lichen sclerosis?

A

A chronic inflammatory disorder of the genitalia, usually first seen in children causing white, raised plaques of skin. Cause is unknown.

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8
Q

What types of cancer can occur at the cervix?

A

Adenocarcinoma (15%) and sqamous cell carcinoma (80%)

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9
Q

How do cervical carcinomas present?

A

screening, intermenstrual bleeding, post coital bleeding, post menopausal bleeding

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10
Q

What is the main cause of cervical cancer?

A

HPV16 and 18

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11
Q

How does HPV cause cancer?

A

Has proteins E6 and E7 which interfere w/ P53 and retinoblastoma protein respectively.

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12
Q

What is CIN?

A

cervical intraepithelial neoplasia- precancerous, noninvasive squamous cell neoplasia

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13
Q

Which part of the cervix is most commonly affected by CIN/ HPV/ cervical cancer?

A

The transformation zone where the epithelium is changing from squamous cell to columnar

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14
Q

How is cervical cancer being prevented?

A
  • screening and excision of invasive malignancies by diathermy
  • HPV vaccine to all 12 and 13 y/o girls
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15
Q

how is cervical cancer treated?

A

hysterectomy, lymph node excision, if advanced: radio and chemotherapy

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16
Q

What is the most common type of endometrial cancer?

A

endometriod endometrial adenocarcinoma (most common invasive cancer of repro tract)

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17
Q

Why does endometriod endometrial adenocarcinoma occur?

A

unopposed oestrogen:
- obesity (more adipose tissue creating oestrogen)
- exogenous oestrogen (HRT, Pill, tamxoifen from breast cancer treatment)
- hormone secreting tumours
It causes endometrial hyperplasia which can progess to cancer

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18
Q

what does endometrial cancer most commonly present with?

A

irregular or post menopausal bleeding

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19
Q

How can endometrial cancer spread?

A

myometrial invasion, extension to adjacent structures, local lymph nodes and distant sites

20
Q

What is the name for the benign and the malignant tumour of the myometrium?

A

Benign: leiomyoma (fibroid)
Malignant: uterine lyeimyosarcoma - these do not arise frmo leiomyomas, their aetiology is unknown

21
Q

How may leimyomas present?

A

Often asymptomatic and you may have many and never know.

Or: bleeding, heavvy periods, urinary frequency (compress bladder) or infertility

22
Q

How common is uterine leiomyosarcoma? what is the prognosis like?

A

very rare

prognosis bad as aggressive, commonly goes to lungs .

23
Q

What are the 4 types of ovarian tumours?

A
  • mullerian epithelium (inc endometriosis)- most common
  • germ cells
  • sex cord stromal
  • mets
24
Q

What are the 3 types of mullerian ovarian tumours?

A
  • serous
  • mucinous
  • endometroid
25
Q

What causes serous ovarian tumours?

A

repeated breaking and repair of the serous membrane due to ovulation

26
Q

What protects you from serous ovarian tumours?

A

the pill, pregnancy and low age (fewer ovulations the better)

27
Q

How do serous ovarian tumours commonly present?

A

with ascites due to spread through peritoneum. also abdo pain, distension, urinary and GI symptoms

28
Q

What are mucinous ovarian tumours like?

A

large cystic masses which are filled with sticky thick fluid (mucus)

29
Q

What type of tumours are most germ cell ovarian tumours? What else can you get?

A

Teratomas- benign

Can also get dysgerminoma, yolk sac tumour, choriocarcinoma ect

30
Q

What are the three types of teratomas?

A

mature (common)- benign
Immature (uncommon)- malignant and resemble fetal tissue
Monodermal (highly specialised)
All three can be cystic, contain hair and teeth and occur in young women

31
Q

What can granulosa cell tumours cause?

A

commonly secrete oestrogen so can cause endometrial hyperplasia and adenocarcinoma as well as precocious puberty

32
Q

Where are the most common primary sites for ovarian mets?

A

Mullerian epitheilum tumours, GI and breast

33
Q

What is a kruckenberg tumour?

A

Metastaic cancers in the ovaries originating from the GI tract, most commonly the stomach

34
Q

What are the 2 origins of testicular cancers?

A

germ cell or sex cord stromal, lymphomas can also affect the testis

35
Q

How common are sex cord stromal cell cancers in the testis?

A

Theyre uncommon and benign. They arise from the sertoli or leydig cells.

36
Q

What may increase risk of testicular cancer?

A

some genes and also cryptorchidism (undecended testis) and the surgery to repair it

37
Q

What are the two groups of germ cell tumours?

A

Seminomas and non seminomas (roughly 50% are each)

38
Q

In what age groups do seminomas, yolk sac tumours, choriocarcinomas, embryonal carcinomas and teratomas arise in?

A

Seminomas= 40-50y/os
Yolk sac= young children
Embryonal and choriocarcinomas= young adults
Teratomas= any age

39
Q

What is the alpha fetoprotein and hCG status in seminomas?

A

a- fetoprotein is normal

hCG is raised in 10% cases

40
Q

Where do seminomas metastasis to?

A

illiac or paraortic nodes- this is only after many yrs and further spread is rare

41
Q

How are seminomas treated?

A

radiotherapy and/ or radial orchiectomy (cut it out)

42
Q

What is the a- fetoprotein and hCG status in yolk sac tumours?

A

a- fetoprotein almost always high

hCG sometimes high

43
Q

What tumour almost always raised hCG?

A

choriocarcinoma

44
Q

What is the AFP and hCG status in someone with a teratoma?

A

AFP and hCG almost never raised

45
Q

Where do non seminomas metastasis to and how commonly to they do it?

A

Regional lymphatics and to other areas by blood vessels. This is relatively common and my be the presentation as the testicular lumps may be undetectable

46
Q

How are non seminomas treated?

A

chemotherapy after an orchiectomy

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