Endometrial Cancer Flashcards
Endometrial cancer is a
Hyper Estrogenic state
Excessive Estrogen and excessively ovulation
Risk factors of endometrial cancer
Family history
Hypertension
Obesity
Atypical uterine bleed
Unopposed oestrogen in pcos
Nulliparity
Tamoxifen theraphy
Why is tamoxifen therapy is considered as a risk factor for endometrial cancer
Selective Estrogen receptor modulator
Antagonist effect on the Breast
Agonist effect on the endometrium
Estrogen alone leads to
Endometrial cancer
Estrogen and progesterone leads to
Breast cancer
Corpus cancer syndrome
Increased chance of cancer in the obese
Diabetic
Hypertension patients
Which is better tamoxifen or raloxifen
Raloxifen as there are no side effects like endometrial cancer and Genitourinary symptoms
What is the familial inheritance involved in the endometrial cancer
Lynch syndrome2
60-70 percent increased
Brca 1 and BRCa 2
Cowdensyndrome pten gene
Lynch»»>cowden
Genes involved in the lynch syndrome
Mlh1
Msh2
Most common cancer involved in the lynch syndrome is
Colorectal cancer then
Endometrial cancer 2 commo
Protection against endometrial cancer
Physical exercise
Smoking
Multiparity
Pregnancy
Ocps
Breast feeding
Classification of endometrial cancer
Types
Histopathogical
Grade
Gatekeeper of endometrial cancer
Cowden
What are the histological varieties of endometrial cancer a
Adenocarcinoma most common
Clear cell variety
Serous variety
Papillary serous variety
Grades
- Well
2 moderate
3 poor differentiated
Most malignant histological variety is
Clear cell type >serous papillary
Explain type 1 tumour
Adenocarcinoma grade1 and grade 2
Increased Estrogen
Pten Kara’s gene mutations
Good prognosis
Obese female and endometrial hyperplasia
Seen in comparatively 50-70
Type 2 endometrial cancer
Adenocarcinoma grade 3
Clear cell carcinoma and papillary serous tumours
Not related to Estrogen
Not associated with the genes
Thin females
P53 mutation
Bad
65-70 yrs
Type1 associated with
Cowden
Lynch
Hnpcc
Most common age
60 yrs
Most comm symptoms for endometrial cancer
Is irregu bleeding >post menopausal bleeding
Indications of endometrial biopsy
Post menopausal bleeding with thickness>4mm
Aub patient with >45 yrs
Reproductive age with thickness >12mm
Indications for fractional currentage after endometrial biopsy
Inadequate sample
Hyperplasia with atypia
Normal but patient continues to bleed
Cervical stenosis
Other investigations in the endometrial cancer
Pap smear post coital bleeding
Ct lymph nodes metastasis
MRI done to know whether the lower uterine segment , myometrium cervix is involved
Most common route of spreading
Direct spread
Most common hematogenous spread is
Lungs
How to differentiate serous variety from ovarian cancer
Ca125 levels raised
Peritoneal spread is there
