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repro > Endometrial carcinoma, cysts and ovarian cancer > Flashcards

Endometrial carcinoma, cysts and ovarian cancer Flashcards

1
Q

endometrial carcinoma - peak incidence?

A

60

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2
Q

uncommon under?

A

40

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3
Q

in young women with endow carcinoma, consider? (2)

A

POS or lynch syndrome

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4
Q

most endometrial carcinomas are?

A

adenocarcinomas

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5
Q

2 main types?

A

endometroid (and mucinous), serous (and clear cell)

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6
Q

which is the most common ?

A

endometroid (80%)

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7
Q

precursor for endometroid?

A

atypical hyperplasia

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8
Q

precursor serous?

A

serous epithelial intraepithelial carcinoma (isis)

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9
Q

how do endometrial cancers usually present?

A

abnormal bleeding

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10
Q

how do they spread (ah dunno)

A

haematogenous, lymphatic, direct spread

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11
Q

type 1 tumours - related to?

A

unopposed oestrogen

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12
Q

what gene often mutated in type 2?

A

TP53 - these tumours are not related to unopposed oestrogen

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13
Q

which type of tumour more seen in elderly, post menopausal women?

A

serous

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14
Q

PTEN, KRAS and PIK3A mutations associated with?

A

type 1

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15
Q

microsatellite instability?

A

type 1

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16
Q

describe how obesity is a risk factor for endometrial carcinoma?

A

fat cells express aromatase. converts androgens into oestrogen (oestrione) e1. causes endometrial proliferation. sex hormone binding globulin lower in obese women, so there are higher levels of free unbounded hormone. also less insulin binding globulin. Insulin and IGF exert proliferative effect on endometrium

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17
Q

cancer pre disposition syndrome, high risk of colorectal cancer and endometrial cancer?

A

lynch

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18
Q

how is it diagnosed?

A

immunochemistry staining of the tumour for mismatch repair proteins can help identify tumours due to lynch syndrome

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19
Q

which are more aggressive? endometroid or s?

A

s, they need more extensive surgery and adjuvant chemo/radiotherapy used more frequentlty

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20
Q

serous carcinomas are characterised by a complex papillary and/or glandular architecture with diffuse, marked nuclear pleomophism

A

endometrial carcinoma typically infiltrates myometrium, while serous spreads earlier to peritoneal cavity

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21
Q

treatment of endometrial cancer?

A

hystorectomy/radiotherapy

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22
Q

staging of endometrial cancer 1-?

A
  1. with 4 being invading bladder/bowel/disant mets
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23
Q

carcinosarcome - what grade?

A

high grade, usually poor outcome

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24
Q

fibroids associated with?

A

menorrhagia, infertility, most common cause of pelvic mass, pressure symptoms, tenderness

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25
Q

what is a fibroid?

A

smooth muscle tumour

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26
Q

leiomyosarcoma - bulky uterus, heavy bleeding, infertility, what kind of morphology?

A

spindle cell

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27
Q

differentiate benign from malignant?

A

malignant causes vaginal bleeding. has poor prognosis

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28
Q

commonest cause of uterine mass?

A

fibroma

29
Q

when do you get polyps?

A

perimenopause

30
Q

who gets fibroids?

A

very common in over 40s

31
Q

how do you diagnose them?

A

ultrasound

32
Q

buzzword?

A

smooth echogenic mass, often multiple

33
Q

management?

A

watch and wait - hysterectomy if family complete

34
Q

sausage shape uterine tube?

A

hydrosalpinx - distally blocked

35
Q

fallopian tube filled/distended with pus?

A

pyosalpinx

36
Q

paratubal cyst?

A

usually small and incidental

37
Q

functional cysts - rarely over 5 cm, when wold they cause pain?

A

if they bleed or rupture

38
Q

what can cause blood filled cysts in the ovaries?

A

endometriosis

39
Q

pre menstrual pain, painful sex, severe painful menstruation?

A

endometriosis blood filled cysts

40
Q

why would sex cause pain cysts

A

moves and twists them

41
Q

TENDER MASS WITH NODULARITY AND TENDERNESS BEHIND UTERUS

A

endometriosis, blood filled cysts

42
Q

what type of cysts rupture?

A

chocolate cysts

43
Q

5 surface epithelium ovarian tumours?

A

serous, mucinous, enometriod, clear cell, brenner

44
Q

why can you not pick up a teratoma with US?

A

doesn’t pick up fat

45
Q

remember if its a stomal cell tumour, it can secrete oestrogen (granuloma), theca leydic can secrete androgens.

A

y

46
Q

what is meigs syndrome?

A

ascites, pleural effusion, benign ovarian tumour

47
Q

where are the most common sites for cancer spread to ovary?

A

breasts, stomach, pancreas

48
Q

why do you get ascites in ov cancer?

A

cancer cells irritate lining of peritoneum and cause fluid to build up

49
Q

nullparity is a rsk factor, why?

A

having a child is a rest period for ovaries

50
Q

imaging - what is better to image nature of the cyst?

A

US

51
Q

what would you use to look for mets?

A

CT

52
Q

CA125 - raisd in what percentage of oc?

A

80

53
Q

does a normal level exclude cancer?

A

no

54
Q

treatment of ovarian cancer?

A

removal of ovaries and uterus and inspection of all peritoneal surfaces

55
Q

cure likely?

A

no, unless confined to ovary at time of presentation

56
Q

ascites*** common complication

A

would do a bimanual examination

57
Q

what is low albumin relevant for in ovarian cancer?

A

albumin is a prognostic indicator

58
Q

for suspected ovarian cancer, what imaging technique would you use?

A

CT, if suspect ovarian cancer, open surgery

59
Q

why do follicular cysts form

A

when ovulation doesn’t occur. i.e. follicle doesn’t rupture, grows until it becomes a cyst

60
Q

how long do they take to resolve?

A

a few months

61
Q

pain, cyst formation, ectopic pregnancy, adhesions, infertilit, malignancy?

A

endometriosis

62
Q

serous, mucinous, endometroid, clear cell, brenner, undifferentiated - what are they?

A

epithelial cell tumours of ovary

63
Q

serous carcinoma - 2 types?

A

high grade and low grade

64
Q

endometroid and clear cell - strong association with? 2 things

A

endometriosis and lynch syndrome

65
Q

usually a benign tumour, malignant variants are rare?

A

brenner

66
Q

germ cell tumour (teratoma) rarely becomes malignant

A

sex cell stream tumours - FGS fibroma, granolas, sertoli

67
Q

4 places you get spread of cancer to the ovary?

A

stomach, breast, colon, pancreas

68
Q

inflammation of the fallopian tubes?

A

salpingitis

repro (30 decks)

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