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3. Conditions: Gynaecology > Endometrial Cancer > Flashcards

Endometrial Cancer Flashcards

1
Q

What are the genetic causes of endometrial cancer?

A

PTEN
K-ras
MMR gene
- HNPCC

P53

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2
Q

What are the types of cancer in endometrial cancer?

A

Adenocarcinoma

Serocarcinoma

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3
Q

What gene mutation causes serocarcinoma?

A

HER-2

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4
Q

What are non genetic causes of endometrial cancer?

A

Mifepristone use

Tamoxifen use

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5
Q

What is the pathology of adenocarcinoma?

A

Unopposed oestrogen

–>

Endometrial proliferation

–>

Endometrial hyperplasia

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6
Q

What conditions may cause unopposed oestrogen?

A

PCOS

Nulliparity

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7
Q

Typical presentation?

A

” 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.

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8
Q

DDx for post menopausal bleeding?

A

Endometrial polyp

Cervical cancer

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9
Q

Investigation for post menopausal bleed?

A

Bimanual vaginal exam

  • Uterine mass
  • Fixed uterus
  • Adnexal mass

TVUS

Hysteroscopy with biopsy

Bloods

MRI

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10
Q

What bloods are done?

A

FBC
- Anaemia

Serum Ca-125

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11
Q

What may a high Ca-125 be caused by?

A

Extra-uterine disease

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12
Q

What Ca-125 level may indicate extra uterine disease?

A

<35units/ml

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13
Q

What is MRI used for?

A

Staging

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14
Q

What may be seen on hysteroscopy?

A

Uterine mass

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15
Q

What is the staging of endometrial cancer?

A

FIGO Staging

International Federation of Gynaecological Oncology

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16
Q

What is stage 1?

A

Confined to uterus

17
Q

What is stage 1A?

A

<50% myometrial invasion

18
Q

Stage 1B?

A

> 50% myometrial invasion

19
Q

Stage 2?

A

Tumour invades cervix

20
Q

Stage 3?

A

Regional spread?

21
Q

Stage 3A?

A

Tumour invades uterus serosa

22
Q

Stage 3B?

A

Vaginal/parametrial spread

23
Q

Stage 3C?

A

Pelvic/para-aortic lymph spread

24
Q

Stage 4A?

A

Invasion of bladder/bowel

25
Q

Stage 4B?

A

Distant mets

26
Q

FIGO Staging summary

A

Stage 1A: <50% myometrial
1B: >50% myometrium

2: Cervix

3A: Uterine serosa
3B: Vaginal invasion
3C: pelvic/para-aortic lymph

4A: Bladder/bowel
4B: Distant mets

27
Q

Treatment for cancer in situ?

A

Hysterectomy

Fertility sparing

28
Q

What drug can be used for fertility sparing?

A

megestrol

29
Q

Treatment of stage 2?

A

Hysterectomy

Chemo

Radiotherapy

30
Q

What chemo drugs can be used in endometrial cancer?

A

Paclitaxel

Carboplatin

31
Q

Treatment stage 3/4?

A

Bilateral salpingo-oophorectomy
Chemo
Radio

3. Conditions: Gynaecology (24 decks)

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