Endometrial Hyperplasia and CA Flashcards
what is the relationship between endometrial thickness and risk of endometrial CA?
increased thickness increases risk
t or f: endometrial hyperplasia is considered a precancerous condition
TRUE
which type of endometrial hyperplasia has the highest likelihood of professing to CA?
complex atypical hyperplasia (noting that atypical hyperplasia is more likely to progress to CA in older women than in those younger)
what is the gold standard diagnostic test for endometrial CA?
biopsy of the endometrium
women with this syndrome have a 40-60% lifetime risk of developing endometrial CA which is equal to their risk of developing colorectal CA
Lynch Syndrome (hereditoary nonpolyposis colorectal CA)
what are some of the side effects of progestin?
WTHEH: weight gain, thrombophlebitis, headache, edema, HTN
t or f: endometrial CA is the most gynecologic CA in the US
TRUE : should be followed by cervical and then ovarian
t or f: endometrial CA is often diagnosed in its early stages
TRUE - it often presents with obvious symptoms
what are the two types of endometrial CA? which is more common?
type I (more common) - dependent on estrogen that begins as proliferation of normal tissue; type II is unrelated to estrogen or hyperplasia and and tends to present both as higher grade and more aggressive
what is the mainstay of treatment for mostly all the different types of endometrial hyperplasia?
cyclical progestin therapy; it progresses to continuous progestin as the severity increases and eventual hysterectomy if need be.
which symptom is present 90% of the time for endometrial CA?
abnormal bleeding
t or f: pap smears are diagnostic for endometrial CA
FALSE
what are some differential diagnoses for endometrial CA?
endometrial hyperplasia, exogenous estrogen, endometrial polyps/cervical polyps, coagulopathy.
t or f: liver disease is a risk factor for endometrial CA?
TRUE (b/c a healthy liver is thought to be able to metabolize estrogens)
what are some risk factors for endometrial CA?
obesity, early menarche/late menopause, PCOS, DM, HTN, tamoxifen tx for breast CA
what is the diagnostic TOC for evaluation of post menopausal bleeding?
endometrial biopsy and D&C hysteroscopy of bx is not adequate
of what histologic subtype are most endometrial cancers?
endometroid
t or f: hyperplasia without atypia has the same risk of progressive to CA as hyperplasia with atypia
FALSE: much lower without atypia
how is endometrial CA staged?
clinically (and again, as the stages increase in number the more widespread/invasive the CA is)
what is the most important prognosticator in endometrial CA?
grade
in comparison to G1, is G3 more or less well differentiated?
LESS (IOW, poorly differentiated)
what is the basic treatment for all stages of endometrial CA?
TAH, BSO
adjuvant chemo includes doxorubicin and cisplatin - what are some common side effects of these drugs?
dox: cardiotoxicity; cis: nephrotoxicity
pt presents with rapidly enlarging mass with bleeding - what’s the diagnosis?
VERY RARE - but uterine sarcoma (less than 1% of fibroids progress to CA)
t or f: leiomyosarcomas are approx. 1/3 of all uterine sarcomas
TRUE
