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OB/GYN > EXAM #1: ENDOMETRIAL CANCER > Flashcards

EXAM #1: ENDOMETRIAL CANCER Flashcards

1
Q

What is the most common invasive carcinoma of the female genital tract?

A

Endometrial carcinoma

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2
Q

What is endometrial carcinoma?

A

Malignant proliferation of endometrial glands

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3
Q

What are the risk factors for endometrial carcinoma?

A

All related to estrogen exposure:

1) Early menarche/late menopause
2) Nulliparity
3) Infertility with anovulatory cycles
4) Obesity

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4
Q

How does estrogen lead to endometrial carcinoma?

A
  • Uncontrolled estrogen causes endometrial proliferation

- Prolonged stimulation may cause hyperplasia

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5
Q

What are protective factors for endometrial carcinoma?

A

1) Ovulation
2) Progestin therapy
3) Combination oral contraceptives
4) Menopause before 49
5) Normal weight
6) Multiparity

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6
Q

What is the most common type of endometrial/uterine carcinoma?

A

Adenocarcinoma

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7
Q

What are the two paths to endometrial carcinoma? Which is more common?

A

1) Hyperplasia*
2) Sporadic

*Most common

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8
Q

In a post-ovulatory/ secretory endometrium, how will the endometrial glands appear?

A

Saw-tooth

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9
Q

Histologically, how does endometrial hyperplasia appear?

A

Hyperplasia of the endometrial glands relative to the stroma

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10
Q

What is the most important predictor for progression of endometrial hyperplasia to carcinoma?

A

Cellular atypia

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11
Q

What combination of hyperplasia and atypia typically progresses to endometrial carcinoma?

A

Simple hyperplasia + cellular atypia

*Complex hyperplasia without atypia rarely progresses to carcinoma.

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12
Q

How does endometrial carcinoma present?

A

Postmenopausal bleeding

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13
Q

How does endometrial hyperplasia present?

A

Postmenopausal bleeding

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14
Q

What is an endometrial polyp?

A

Hyperplastic protrusion of the endometrium

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15
Q

What imaging study can be used to evaluate for an endometrial polyp?

A

Sonohystogeram

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16
Q

In treating a woman of reproductive age with abnormal uterine bleeding, you perform an endometrial biopsy. There is no cytologic atypia. Simple hyperplasia is seen. What do you do?

A

Intermittent progestin

17
Q

In treating a woman of reproductive age with abnormal uterine bleeding, you perform an endometrial biopsy. There is no cytologic atypia. Complex hyperplasia is seen. What do you do?

A

Intermittent or cont. progestin

18
Q

In treating a woman of reproductive age with abnormal uterine bleeding, you perform an endometrial biopsy. There is simple/mild cytologic atypia. What do you do?

A
  • Intermittent progestin

- Biopsy again in 3-6 months

19
Q

In treating a woman of reproductive age with abnormal uterine bleeding, you perform an endometrial biopsy. There is moderate to severe cytologic atypia. What do you do?

A
  • Cont. progestin

- Biopsy again in 3-6 months

20
Q

What is an abnormally thick endometrium in a post-menopausal woman?

A

Thickness greater than 4mm

21
Q

If you suspect advanced stage endometrial cancer, what imaging should you get?

A

1) CT of the abdomen and pelvis

2) +/- chest CT

22
Q

What is the gold standard surgical intervention for endometrial carcinoma?

A

TAHSBO

23
Q

How does endometrial cancer spread?

A

1) Local extension
2) Lymphatic
3) Hematogenous (rarely)

24
Q

Though the presenting symptom of endometrial carcinoma is post-menopausal bleeding, is this the most common cause of post-menopausal cancer?

A

NO

*DDx= endometrial hyperplasia and endometrial polyp

25
Q

What should you do if abnormal endometrial cells around found on pap smear in an asymptomatic woman?

A

Endometrial biopsy

26
Q

What are the most critical factors in determining the prognosis of endometrial carcinoma?

A

Tumor, grade, and histology

27
Q

What is the second most critical factor in determining the prognosis for endometrial carcinoma?

A

Depth of invasion

28
Q

What is a uterine sarcoma?

A

Neoplasm composed of the uterine myometrium/stroma

29
Q

How does the prognosis for uterine sarcoma compare to adenocarcinoma?

A

Sarcoma has a poorer prognosis

30
Q

Some ovarian cancers likely originate from what organ?

A

Fallopian tube

31
Q

What is the primary risk factor for fallopian tube cancer?

A

BRCA1/2

*Also infertility and low parity

32
Q

What type of cancer are most fallopian tube cancers?

A

Adenocarcinomas

33
Q

What should you think if you see expulsion of clear or serosanguineous fluid from the vagina?

A

Fallopian tube cancer

*This is hydrops tubae profluens

34
Q

What is Latzko’s Triad?

A

1) Hydrops tubae profluens
2) Colicky pain
3) Mass

OB/GYN (19 decks)

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