Endometrial Cancer Flashcards
What is type 1 endometrial cancer ?
Endometrioid adenocarcinoma grade 1 & 2 drive from atypical endometrial hyperplasia
What is type 2 endometrial cancer ?
Endometrioid adenocarcinoma grade 3 and tumors of non endometrioid histology
Features of type 1 endometrial cancer ?
Related to exposure to increase estrogen
Genetic mutation PTEN
Features of type 2 endometrial cancer ?
Estrogen - independent
Associated with endometrial atrophy ( post menopausal)
Risk factors for type 1
Nulliparity
Early or late menarche
PCOS
obesity and type 2 DM
Unopposed estrogen replacement therapy
Lynch syndrome
Tamoxifen treatment
What are the general clinical features?
- abnormal uterine bleeding
- pelvic exam ( uterus may be enlarged )
What are the regional extension clinical features ?
1) pelvic pain
2) vaginal mass or bleeding
3) abnormality on cervix
4) changes in bowel function
What are the metastatic disease clinical features ?
1) lymphogenic and Hematogenous
2) WL
3) symptoms of mass effects
4) cough
5) pleural effusion
What is the initial diagnosis for AUB ?
1) CBC for anemia
2) coagulation study
3) pregnancy test
What is the diagnosis for post menopausal women ?
1) endometrial biopsy with histology
2) TVUS
What is seen in trans vaginal ultrasound ?
1) mass
2) endometrial thickness
How is endometrial biopsy + histology taken ?
By hystroscope guided dilation and curratage
What are the endometrial biopsy + histology findings ?
- endometrial hyperplasia with atypi ( premalignant )
- endometrial carcinoma
- serous adenocarcinoma
What is the treatment for if a disease is confined to the endometrium and myometrium and in post monepausual patient and the one who don’t want to perserve their fertility ?
Total hysterectomy with bilateral salpingo ophrecotomy
What is the treatment for if a disease is confined to the endometrium and myometrium and in patients who want to perserve their fertility
Uterine preservation consist of progestins
