Gyn malignancy Flashcards
Cervix CA- Eti
- Persistant HPV
- STI, smoking, sex at young age, immunosupression
- Low SES
- 2nd most leading cause of CA death worldwide
- Progressive dysplasia leads to invasive
Cervix CA- sx
- Abd pain
- Bleeding after intercourse
- Grossly abn cervix- yellow- tan course tissue
- Enlarged uterus
- Fixed, sticky uterus
Cervix CA- Dx
- Punch & ECC visible lesions
- Check endocervical canal
Cervix CA- Tx
Surgery, radiation & chemo depending on stage
Endometrial CA- Epi
- Most common gyn CA
- 4th most common
- 75% postmenopausal
- Obesity, estrogen, anovulation, PCOS, fam hx, tamoxifen
- Type 1- 80%, type II poorer prognosis
Endometrial CA- Sx
- Frank vaginal bleeding
- Wt loss, anorexia & fatigue
- Enlarged uterus, cervical displacement
Endometrial CA- Dx
- Endometrial biopsy- gold standard
- Ultrasound- stripe
Ovarian CA- Eti
- Most often dx at late stage- deadly
- Ovulation suppression decreases risk
- Risks correlate with ovulation suppression
- Fam hx
Ovarian CA- Sx
- No early gyn sx
- Abd bloating, constipation, incontinence
- Heartburn, change in bowel pattern
- Ascites
- RUQ tenderness, adnexal mass
- Fatigue, unexplained wt loss
Ovarian CA- Dx
- Transvaginal US
- CT scan
- CA125 on postmenopausal with pelvic mass
Vulvar CA- Sx
- Pruritis
- Fleshy, nodular or warty lesion
- Benign appearing
- Melanoma
Vulvar CA- Dx
- Biopsy
Vulvar CA- Eti
- HPV mediated- dysplasia to CA in 60%
- Inflammatory/ autoimmune (lichen sclerosis) in 40%
Vulvar CA- Tx
Resection or radiation
Vaginal CA- Eti
- Rare
- Squamous cell, HPV mediated
- 60 yrs
Vaginal CA- Sx
Vaginal, post coital bleeding
- Mass, plaque or ulcer
Vaginal CA- Dx
Biopsy & pap
Hydatiform mole- Eti
- Gestational trophoblasitc neoplasia
- Asians
- Risks: prior spontaneous abortion, hx of mole, age 35
- Cytogenic comp: 46, XX or paternal origin
Hydatiform mole- Sx
- Excessive N/V
- Irregular uterine bleeding 6-16 wks
- Large uterus
- Beta hCG > 40,000
- Passage of grape like clusters per vagina
- No fetus or placenta
Hydatiform mole- Dx
- Ultrasound
- B-hCG high
Hydatiform mole- Tx
- MethotrexateIM or actinomycin IV
- Suction & curratge
Choriocarcinoma- Eti
Presence of detectable B-hCG after mole evacuation
- Malignancy
Choriocarcinoma- Sx
- Continued or recurrent bleeding
- Following mole, delivery, abortion or ectopic pregnancy
- Ulcerative vag. tumor, pelvic mass or distant METs
Choriocarcinoma- Dx
- B-hCG elevation
- CXR for pulm mets
Choriocarcinoma- Tx
-Chemo until zero hCG titer
Breast CA- Eti
- 2nd common most CA
- 2nd common cause of CA death
- Risk increases thru 60, peaks at 70, declines
- whites
- Hereitable
- Alcohol, 1 preg > 30, contraceptive use
Breast CA- Sx
- Painless lump
- Breast pain, discharge, erosion, retraction or enlarged nipple
- Asymmetry
- Axillary, supra/infraclvicular nodes
Breast CA- Dx
- Mammography to Biopsy
Breast CA- Tx
- Chemo, mastectomy, radiotherapy
