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
What is the treatment if the lymph node is involved ?
Total hysterectomy with bilateral salpingo orphrectomy
And chemo / radiation
What is the treatment for metastatic ?
Palliative therapy
Surgical tumor reduction or medical therapy
