CPC of the Uterus Flashcards
discuss transvaginal USS to measure endometrial thickness
§ Measure endometrial thickness § Looks at the endometrial contour § Biopsy if >4mm or irregular • Atrophic endometrium should be normal in post menopause. Won't get much tissue in the sample • Endometrial adenocarcinoma
features of endometrial adenocarcinoma
glands
cribiform
enlarged atypical nuclei
pathological prognostic features of uterine ca
- Histological type
- Histological grade
- Stage
- Lymphovascular space invasion (LVSI)
can can you stage endometrial cancer
surgical/pathological
MRI
endometrial cancer staging: 1A
inner half of myometrium
endometrial cancer staging: 1B
outer half of myometrium
endometrial cancer staging: 2
invades cervix
endometrial cancer staging: 3A
serosa/adnexa
endometrial cancer staging: 3B
vagina/parametrium
endometrial cancer staging: 3C
pelvic or para-aortic nodes
endometrial cancer staging: 4
bladder/bowel/intra-abdominal/inguinal nodes
when would it be normal to have endometrial atrophy?
post menopause
type 1 endometrial ca
o Endometrioid adenocarcinoma
o By far the most common
o Unopposed oestrogen
o Hyperplasia with atypia precursor
type 2 endometrial ca
o Uterine serous and clear cells carcinoma
o High grade, more aggressive, poor prognosis
o Generally older ladies
o Serous intraepithelial carcinoma precursor
treatment of endometrial cancer
• Early stage o Surgery TAH/BSO/Washings • High risk histology o Chemotherapy • Advanced stage o Radiotherapy • Palliation o Progesterone • Radiotherapy o External beam • Caesium insertion o Intra-cavity o Vault
