Clinical Pathological Conference of the Uterus Flashcards
How is post-menopausal bleeding investigated?
Trans-vaginal USS
Endometrial biopsy
Hysteroscopy
What is the use of Trans-vaginal USS?
Measure endometrial thickness
Look at endometrial contour
When is Endometrial biopsy indicated?
Trans-vaginal USS shows endometrium >4mm or irregular
What are the prognostic indicators for endometrial cancer?
Histological type
Histological grade
Stage
Lymphovascular space invasion
How is Endometrial cancer staged?
Surgery/pathology
MRI
What can MRI establish in endometrial cancer?
Depth of myometrial invasion
Cervical involvement
Lymph node involvement
What stage is endometrial cancer contained to the inner half of myometrium?
1A
What stage is endometrial cancer contained to the outer half of myometrium?
1B
What stage is endometrial cancer invading the cervix?
2
What stage is endometrial cancer invading the serosa?
3A
What stage is endometrial cancer invading the vagina/parametrium?
3B
What stage is endometrial cancer invading the pelvic/para-aortic nodes?
3C
What stage is endometrial cancer invading the bladder/bowel/abdominal nodes?
4
What are the types of Endometrial cancer?
Type 1:
Endometrioid adenocarcinoma
Type 2:
Uterine serous & clear cell carcinoma (carcinosarcoma)
What is the most common type of endometrial cancer?
Type 1:
Endometrioid adenocarcinoma
How is type 1 endometrial cancer treated?
Prophylactic hysterectomy
How is endometrial cancer treated?
Total abdominal hysterectomy and peritoneal washings
What are the risk factors for endometrial cancer?
Post-menopause
High circulating estrogen
Atypical endometrial hyperplasia
HNPCC/Lynch type II familial cancer syndrome
What are the typical causes of high circulating estrogen in women?
Obesity
Unopposed E2/Tamoxifen
PCOS
Early menarche/late menopause
What are the symptoms of endometrial cancer?
Abnormal vaginal bleeding
Post-menopausal bleeding
What is the palliative management of endometrial cancers?
Progesterone
