Endometrial Carcinomas Flashcards

1
Q

What are the different classes of endometrial carcinomas?

A
  • Type 1 – Endometrioid adenocardinoma
    • Commonest
    • Hyperplasia with atypia precurser
  • Type 2 – uterine serous and clear cell carcinoma
    • High grade, worse prognosis
    • Older woman
    • Serous intraepithelial carcinoma precursor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which class of endometrial carcinomas has worse prognosis?

A
  • Type 1 – Endometrioid adenocardinoma
    • Commonest
    • Hyperplasia with atypia precurser
  • Type 2 – uterine serous and clear cell carcinoma
    • High grade, worse prognosis
    • Older woman
    • Serous intraepithelial carcinoma precursor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which class of endometrial carcinoma is commonest?

A
  • Type 1 – Endometrioid adenocardinoma
    • Commonest
    • Hyperplasia with atypia precurser
  • Type 2 – uterine serous and clear cell carcinoma
    • High grade, worse prognosis
    • Older woman
    • Serous intraepithelial carcinoma precursor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the precurser for type 1 and type 2 endometrial carcinoma?

A
  • Type 1 – Endometrioid adenocardinoma
    • Commonest
    • Hyperplasia with atypia precurser
  • Type 2 – uterine serous and clear cell carcinoma
    • High grade, worse prognosis
    • Older woman
    • Serous intraepithelial carcinoma precursor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which class of endometrial carcinoma affects older woman?

A
  • Type 1 – Endometrioid adenocardinoma
    • Commonest
    • Hyperplasia with atypia precurser
  • Type 2 – uterine serous and clear cell carcinoma
    • High grade, worse prognosis
    • Older woman
    • Serous intraepithelial carcinoma precursor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is the classification of endometrial carcinomas likely to change in the future?

A

Classification is changing, in future likely to be based on molecular findings:

  • Molecular testing on tumour tissue to look for certain mutations and genetic aberrations such as P53 mutations or microsatellite instability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are risk factors for endometrial carcinoma?

A
  • High circulating oestrogen levels
    • Obesity
    • Unopposed E2 therapy
    • Polycystic ovarian syndrome
    • Early menarche/early menopause
  • Endometrial hyperplasia with atypia
  • HNPCC/Lynch type II familial cancer syndrome
  • Post-menopausal
  • Hypertension
  • Diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where does endometrial cancer rank in womans cancers prevalence?

A
  • Uterine cancer in 4th place
  • Ovarian cancer in 6th place
  • (most common is breast, then lungs, then bowel)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the presentation of endometrial carcinoma?

A
  • Abnormal vaginal bleeding
    • Post-menopausal bleeding (PMB) for most woman
    • Intermenstrual or heavy bleeding for people with family history of HNPCC
  • Pain with urination or sexual intercourse
  • Pelvic pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What investigations are done for endometrial carcinoma?

A
  • Trans-vaginal USS
    • Measure endometrial thickness and look at contour
      • Biopsy if >4mm or irregular
  • Endometrial biopsy
    • Such as pipelle endometrial biopsy
  • Hysteroscopy
    • Done if not possible to do pipelle endometrial biopsy or suspicion of underlying pathology
  • MRI
    • Used for staging – depth of myometrial invasion, cervical involvement and lymph node involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is staging of endometrial cancer done?

A

Staging is done by surgical/pathological means and MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the different stages of endometrial carcinoma?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the management for endometrial carcinoma?

A
  • Early stage
    • Total laparoscopic hysterectomy
    • Bilateral salpingoophorectomy
    • With peritoneal washings
  • High risk
    • Chemotherapy
  • Advanced stage
    • Radiotherapy
  • Palliation
    • Progesterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the prognosis of endometrial carcinoma depend on?

A
  • Depends on
    • Histological type
    • Histological grade
    • Stage
    • Lymphovascular space invasion (LVSI)
  • Cure rates for each stage
    • IB – 85%
    • IIA – 75%
    • IIB – 60%
    • IIIB – 30%
    • IV – 21%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly