Endometrial pathology CPC Flashcards
Investigations of PMB
speculum and pelvic examination
trans-vaginal USS
hysteroscopy
Trans-vaginal USS - what are you looking for
endometrial thickness
endometrial contour
biopsy if >4mm of irregular with a pipelle
Hysteroscopy in PMB
visualise and obtain biopsy
Main treatment for endometrial cancer
TAH, BSO with peritoneal washings performed laparascopically
4 pathological prognostic features
histological type
histological grade
LVSI
stage
Staging endometrial cancer
surgery/pathology
MRI
MRI findings in staging
depth of myometrial invasion
cervical involvement
LN involvement
FIGO staging
1a - inner half of myometrium 1b - outer half of myometrium 2 - invades cervix 3a - invades serosa/adnexa 3b - vagina/parametrium 3c - pelvic or para-aortic LN 4 - bladder/bowel/inguinal LN
Is type 1 or 2 endometrial cancer linked to unopposed oestrogen?
1
endometrial cancer type 1
endometrioid adenocarcinoma
unopposed oestrogen eg obesity.HRT
commonest
hyperplasia with atypia precursor
endometrial cancer type 2
uterine serous and clear cell carcinoma
aggressive, poorer prognosis, older ladies
serous intraepithelial cancer precursor
early stage treatment
surgery TAH/BSO/washings
+/- radiotherapy
2 types of radiotherapy used
external beam
caesium insertion - vault or intra-cavity
high risk histology treatment
chemo
advanced cancer treatment
radiotherapy
