Endometrial Cancer Flashcards
What are the genetic causes of endometrial cancer?
PTEN
K-ras
MMR gene
- HNPCC
P53
What are the types of cancer in endometrial cancer?
Adenocarcinoma
Serocarcinoma
What gene mutation causes serocarcinoma?
HER-2
What are non genetic causes of endometrial cancer?
Mifepristone use
Tamoxifen use
What is the pathology of adenocarcinoma?
Unopposed oestrogen
–>
Endometrial proliferation
–>
Endometrial hyperplasia
What conditions may cause unopposed oestrogen?
PCOS
Nulliparity
Typical presentation?
” 65 y/o obese woman with hypertension presents with post menopausal bleeding. She is systemically well. She is nulliparous and had no menopausal issues. Her most recent cervical smear was normal. “
The no menopausal issues means she wasn’t treated with HRT. HRT is a protective factor for endometrial cancer.
DDx for post menopausal bleeding?
Endometrial polyp
Cervical cancer
Investigation for post menopausal bleed?
Bimanual vaginal exam
- Uterine mass
- Fixed uterus
- Adnexal mass
TVUS
Hysteroscopy with biopsy
Bloods
MRI
What bloods are done?
FBC
- Anaemia
Serum Ca-125
What may a high Ca-125 be caused by?
Extra-uterine disease
What Ca-125 level may indicate extra uterine disease?
<35units/ml
What is MRI used for?
Staging
What may be seen on hysteroscopy?
Uterine mass
What is the staging of endometrial cancer?
FIGO Staging
International Federation of Gynaecological Oncology
What is stage 1?
Confined to uterus
What is stage 1A?
<50% myometrial invasion
Stage 1B?
> 50% myometrial invasion
Stage 2?
Tumour invades cervix
Stage 3?
Regional spread?
Stage 3A?
Tumour invades uterus serosa
Stage 3B?
Vaginal/parametrial spread
Stage 3C?
Pelvic/para-aortic lymph spread
Stage 4A?
Invasion of bladder/bowel
