Endometrial Cancer Flashcards
What is the Pathophysiology of Endometrial Cancer?
Uncontrolled estrogen stim causes proliferation of endometrial cells => hyperplasia
Invades endometrial stroma
Penetration of myometrium and invasion lymphatics
What are the cellular traits of Developing Endometrial CA?
Cytologic Atypia with loss of cellular polarity, inc in Nuc/cyto ratio and chromatin clumping occurrs with unopposed estrogen
When does the secretory phase take place?
After ovulation
What is unique about Endometrioid AdenoCA?
Back to back glandular arrangement
Little intervening stroma
Glands lined by tall columnar tumor cells
How is Endometrium evaluated?
Endometrial Biopsy US -masses/anomalies -endo thickness Labs -CBC, Chem7, LFT, Ca-125 EKG, CXR
What is the Tx of Endometrial CA?
Abdominal Hysterectomy
Laparoscopic/robotic
Radiation or progesterone
What is the clinical presentation of Endometrial CA?
Post-menopausal bleeding Abn Cells on cytology Abd pain Hematuria Urinary Freq Rectal Bleed Constipation Hip/Back pain Abdominal Distention
What are the most important Prognostic Factors in Endometrial Cancer?
Tumor, Grade and histology
Depth of myometrial invasion
Staging
Clinical Factors
What is considered abnormally thickened endometrium in Postmenopausal women?
Greater than 4mm thick
How can abnormal bleeding be evaluated?
Endometrial Biopsy
Ultrasound
Hysteroscopic D&C
What is included in Adjuvant therapy for Endometrial CA?
Radiotherapy -Brachytherapy -whole pelvis external beam therapy -pelvis with extended field Hormonal Therapy -progestational agents -anti estrogens Chemotherapy
What are the traits of Uterine Sarcoma?
Arise from myometrium or stromal comp of endometrium
Staging is surgical and same as endometrial adenoCA
What are the traits of Fallopian Tube Cancers?
BRCA mutations are a risk factor
some Ovarian cancers of FT origin
Infertility and low parity are associated
What is Latzko’s triad?
Serosanguinous discharge, colicky pain, mass
