Endometrial cancer Flashcards
what is the pathophysiology of endometrial cancer?
uncontrolled estrogen stimulation causes proliferation and hyperplasia of endometrial cells
what is the histology of endometrial cancer?
cellular atypia with loss of cellular polarity, increase in nuclear : cytoplasmic ratio, and chromatin clumping occurs with unopposed estrogen
what is the most common uterine cancer type?
adenocarcinoma
uterine cancer is usually found in the background of what process?
atypical hyperplasia
what is the histology for proliferative endometrium?
simple tubular endometrial glands are set in prominent stroma (associated with normal estrogen stimulation in a cycling woman)
what is the histology for secretory endometrium?
- endometrial glands are present with a saw tooth pattern
- each gland is an individual unit set in endometrial stroma
what is the histology for simple hyperplasia without atypia? what is the result?
- endometrium shows an increase in glandular epithelium usually as a result of unopposed estrogen stimulation
- results in irregular and unpredictable gland outlines that are often cystic
what is the histology for endometrioid adenocarcinoma?
- back to back glandular arrangement with little intervening stroma
- glands lined by tall columnar cells
most surgical cases of endometrial cancer consist of what procedure?
total abdominal hysterectomy - removal of tubes and ovaries
how does endometrial cancer metastasize?
- local extension
- lymphatic channels
what is the risk of cancer in post menopausal bleeding?
15-25%
what % of patients with endometrial cancer present with post menopausal bleeding?
90%
what is the evaluation for abnormal bleeding?
- endometrial biopsy
- US
- hysteroscopy D&C
what are the most critical prognostic factors for endometrial cancer? what are other factors?
- tumor, grade, histology
- depth of myometrial invasion
- staging
- clinical factors (age, ethnicity)
the extend of surgery for hysterectomy is based on what factor?
depth of invasion - myometrial thickness
