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Reproduction SOH > Endometrial tumours > Flashcards

Endometrial tumours Flashcards

1
Q

Endometrial cancer is most common in pre-menopausal women. True or false?

A

False

- post menopausal women

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2
Q

Endometrial cancer typically infiltrates ______

A

Myometrium

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3
Q

Peak incidence occurs in which age group?

A

50-60 year olds

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4
Q

What are the 2 types of endometrial cancer?

A

Endometrioid carcinoma

Serous carcinoma

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5
Q

What is the main risk factor for endometrial cancer?

A

Obesity

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6
Q

Sex hormone binding globulin levels are HIGHER/LOWER in obese women?

A

Lower

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7
Q

Why is obesity a risk factor for endometrial cancer?

A

Adipocytes express aromatase.
Aromatase converts ovarian androgens -> oestrogens.
Increased level of oestrogen induces endometrial proliferation.

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8
Q

Which condition is associated with endometrial cancer?

A

Lynch syndrome

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9
Q

Endometrial cancer - clinical features

A

Abnormal bleeding

- post menopausal bleeding

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10
Q

Endometrial cancer - investigations

A 
Transvaginal US 
- assess thickness of endometrium 
MRI scan 
- assess degree of myometrial invasion 
CT scan 
- looks for distal nodal mets
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11
Q

Endometrial cancer - how many stages are there

A

4

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12
Q

Endometrial cancer - stage I

A

Confined to uterus
Ia - less than 50% myometrial invasion
Ib - over 50% myometrial invasion

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13
Q

Endometrial cancer - stage II

A

Tumour invades cervical stroma

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14
Q

Endometrial cancer - stage III

A

Local and/or regional tumour spread

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15
Q

Endometrial cancer - stage IV

A

Tumour invades bladder and/or bowel mucosa and/or distant metastases

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16
Q

Endometrial cancer - management if the tumour has not invaded?

A

Hysterectomy

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17
Q

Endometrial cancer - management options

A

Surgery - hysterectomy
Radiotherapy
Chemotherapy

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18
Q

Type 1 tumours

A

Endometrioid (and mutinous) carcinoma

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19
Q

Type 2 tumours

A

Serous (and clear cell) carcinoma

20
Q

Which is most common: Endometrioid (and mucinous) carcinoma OR Serous (and clear cell) carcinoma

A

Endometrioid (and mucinous) carcinoma

21
Q

Which is most aggressive: Endometrioid (and mucinous) carcinoma OR Serous (and clear cell) carcinoma

A

Serous (and clear cell) carcinoma

22
Q

Which type of cancer is relate to unopposed oestrogen? Endometrioid (and mucinous) carcinoma OR Serous (and clear cell) carcinoma

A

Endometrioid (and mucinous) carcinoma

23
Q

What is the precursor for endometrioid (and mucinous) carcinoma?

A

Complex atypical hyperplasia

24
Q

Endometrioid (and mucinous) carcinoma - what are the 3 mutations?

A

PTEN
KRAS
PIK3CA

25
Q

Endometrioid (and mucinous) carcinoma is associated with which syndrome?

A

Lynch syndrome

26
Q

Endometrioid (and mucinous) carcinoma spreads early and most present with extrauterine disease. True or false?

A

False

- usually confined to the uterus at presentation

27
Q

How are Endometrioid (and mucinous) carcinomas graded?

A

By their solidity
Grade 1 - 5% of less solid growth
Grade 2 - 6-50% solid growth
Grade 3 - over 50% solid growth

28
Q

Serous (and clear cell) carcinoma is associated with unopposed oestrogen. True or false?

A

False

29
Q

What is the precursor for Serous (and clear cell) carcinoma ?

A

Serous endometrial intraepithelial carcinoma

30
Q

Serous (and clear cell) carcinoma - mutation

A

P53 over-expression

31
Q

Serous (and clear cell) carcinoma spreads early and most patients present with extrauterine disease. True or false?

A

True

32
Q

Serous (and clear cell) carcinoma - grading

A

Not routinely graded as they are so aggressive

33
Q

Carcinosarcoma - definition

A

Mixed tumour of both gland and storm together

34
Q

High/low levels of oestrogen are said to increase the risk of developing an endometrial malignancy>

A

High

35
Q

The incidence of endometrial cancer is higher/lower in women who take the OCP

A

Lower

36
Q

Name 5 factors which may cause increased oestrogen in the body?

A 
Obesity 
PCOS 
Nulliparity 
Late menopause 
Unopposed ostrogen HRT
37
Q

WHat is the principle symptom of endometrial malignancy?

A

Post menopausal bleeding

38
Q

First line investigation for a woman presenting with post menopausal bleeding

A

TVUSS

- can measure endometrial thickness

39
Q

Name a diagnostic investigation for endometrial cancer?

A

Hysteroscopy + dilation / curetage

40
Q

What is the treatment of endometrial HYPERPLASIA in young women

A

Progestogens medication - eg POP

Mirena IUD - delivers progesterone to the endometrium

41
Q

Cervical stromal invasion (but not beyond uterus) would have which figo stage?

A

II

42
Q

TUmour invasion into bladder and/or bowel would have what stage?

A

IV(a)

43
Q

Tumour invasion into serosa or adenexa would have which stage?

A

III(a)

44
Q

Pelvic / para-aortic lymph node involvement would have which stage?

A

III(c)

45
Q

What is mainstay of treatment

A

Hysterectomy +/- bilateral salpingo-oophrectomy

46
Q

What is the most common site of recurrence for endometrial cancer?

A

Vault of vagina

Reproduction SOH (50 decks)

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