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Repro > Endometrial Cancer > Flashcards

Endometrial Cancer Flashcards

1
Q

Name 3 investigations for Post-menopausal bleeding

A

Transvaginal Ultrasound
Endometrial Biopsy
Hysteroscopy

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2
Q

Which 2 features of the endometrium can be measured/observed using transvaginal ultrasound?

A

Endometrial thickness

Endometrial contour

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3
Q

What is the significance of measuring endometrial thickness in the case of postmenopausal bleeding?

A

Endometrium should not be in cycle of thickening and shedding - no oestrogen or progesterone produced

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4
Q

Why would a biopsy be taken to investigate post menopausal bleeding?

A

Endometrial thickness greater than 4 mm or irregular

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5
Q

What irregularities may be present in the endometrium indicating the need for a biopsy?

A

Polyps

Fluid

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6
Q

How would an endometrium biopsy be sampled?

A

Pipelle

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7
Q

What are the typical findings from a hysteroscopy in a postmenopausal patient?

A

Thin
Atrophic
Pale

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8
Q

Treatment for postmenopausal bleeding

A

Total Laparoscopic Hysterectomy
Bilateral salpingoophorectomy BSO
Peritoneal washings

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9
Q

In what settings can a hysteroscopy be carried out?

A

Inpatient under General Anaesthetic

Outpatient under Local Anaesthetic

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10
Q

4 Pathological Prognostic Features in Endometrial cancer

A

Histological Type
Histological Grade
Stage
Lymphovascular Space Involvement LSI

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11
Q

What is meant by the histological grade of an endometrial cancer?

A

Proportion of gland formation

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12
Q

2 purposes of Staging of endometrial cancer

A

Surgical

Pathological

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13
Q

What imaging technique is used to stage Endometrial Cancer?

A

MRI

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14
Q

What is measured on MRI to stage an endometrial cancer?

A

Depth of myometrial invasion
Cervical involvement
Lymph node involvement

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15
Q

What is the name of criteria used to stage endometrial cancer?

A

FIGO

2009

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16
Q

Describe the endometrial cancer staging FIGO criterai

A 
1A - Inner half myometrium
1B - Outer half myometrium 
2 - Invades cervix
3A - Serosa/adnexa
3B - Vagina/Parametrium
3C - Pelvic or Paraaortic nodes
4 - Bladder/Bowel/Intra-abdominal/Inguinal nodes
17
Q

How many types of endometrial cancer are there?

A

Type 1 and Type 2

18
Q

What is the most common type of endometrial cancer?

A

Type 1

19
Q

What type of tumour is type 1 endometrial cancer?

A

Endometroid adenocarcinoma

20
Q

Which type of endometrial cancer is common in premenopausal and obese patients?

A

Type 1

21
Q

Histological findings in Type 1 Endometrial cancer

A

Hyperplasia with atypia precursor

22
Q

Describe the tumour of Type 2 Endometrial cancer

A

Uterine serous and clear cell carcinoma

23
Q

Which type of endometrial cancer has a worse prognosis?

A

Type 2 - high grade, more aggressive

24
Q

In which group of patients is Type 2 Endothelial cancer more common?

A

Late menopausal - generally older women

25
Q

Which type of precursor is found in Type 2 Endothelial cancers?

A

Serous intraepithelial carcinoma precursor

26
Q

Which type of cells are produced by a uterine carcinosarcoma and how does it behave?

A

Bone and cartilage

Very aggressive

27
Q

Treatment of early stage endometrial cancer

A

Total Abdominal Hysterectomy
Bilateral Salpingoopherectomy
Peritoneal washings

28
Q

Treatment of endometrial cancer with high risk histology

A

Chemotherapy

29
Q

Treatment of advanced stage Endometrial Cancer

A

Radiotherapy

30
Q

How is endometrial cancer palliated?

A

Progesterone

31
Q

4 Factors/Patient groups found in cases of endometrial cancer

A

Post menopausal
High circulating oestrogen levels
HNPCC/Lynch Type II Familial cancer syndrome
Atypical endometrial hyperplasia

32
Q

Symptoms of endometrial cancer

A

Post menopausal bleeding

Abnormal vaginal bleeding

33
Q

Reasons for postmenopausal bleeding (6)

A 
Endometrial cancer (8%)
Hormone Replacement Therapy
Perimenopausal bleeding
Atrophic vaginitis
Polyps - cervical/endometrial
Other cancers - cervical/vulva/bladder/anal
34
Q

Three features of atrophic vaginitis

A

Post coital bleed
Non infectious
Tissue undergone early trauma
Thinner - Dehydration

35
Q

Diagnosis of Endometrial cancer

A

Histology of endometrium

36
Q

Reasons for high circulating levels of oestrogen

A

Obesity - peripheral production
Unopposed E2 therapy/Tamoxifen
Polycystic Ovarian Syndrome PCOS
Early menarche/late menopause

37
Q

Why does PCOS cause a high circulating level of oestrogen

A

Anovulation - no fall in oestrogen levels

38
Q

What effect does early menarche/late menopause have on endometrium?

A

Allows it to thicken, create space

Myometrium effects occur as well

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