Gynae Cancers Flashcards
What is the most common type of ovarian cancer?
Epithelial cell adenocarcinoma - mostly serous carcinomas
Accounts for 80-90% of all ovarian tumours
Why does ovarian cancer have such low assocaited survival rates?
Late presentation due to vague symptoms
What are the symptoms of ovarian cancer/
Abdominal pain Bloating Diarrhoea Early satiety Loss of appetite
Tends to mimic IBS
What are some of the risk factors for ovarian cancer?
BRCA 1 and 2 genes
FHx
Many ovulations - Nulliparity, early menarche and late menopause
Lynch syndrome
What are the appropriate investigations for ovarian cancer?
CA-125 (raised in 80% of epithelial cancers)
USS of pelvis
Staging CT or MRI
Transvaginal scan
Ascites / pleural effusion sample can be sent
What staging system is used for ovarian cancer?
FIGO system
If ovarian cancer is limited to the pelvis what stage is it?
Stage 2
If ovarian cancer is described as stage 3 what does that mean
It is limited to the abdomen, which includes regional lymph node mets
What stage is an ovarian cancer when it is limited to one or both ovaries, if peritoneal washouts are positive or tumour is present on the ovary surface?
Stage 1
What stage of ovarian cancer involves distal mets?
Stage 4
What type of incision in surgery carries the best progosis for ovarian cancer?
Midline incision for staging laparascopy
What is involved in a staging laparascopy?
Midline laparotmy HYsterectomy Bilateral salpingo oophorectomy Omentectomy Para-aortic lymph node and pelvic lymph node sampling PEritoneal washouts and biopsies
What type of chemotherapy agents are best for ovarian cancer?
Platinum based - e.g. carboplatin
+ paclitaxel for even better outcomes
What malignancy can occur from gestational trophoblastic disease?
Choriocarcinoma
What are some of the characteristics of borderline ovarian tumours?
Epithelial in nature Not benign Seen in premenopausal women usually confined to one ovary difficult to histologically diagnose Much better prognosis
What is the name of an extremely rare tumour which can arise from a primary appendix tumour or a mucinous cystadenoma?
Pseudomyxoma peritonei
List 8 differnt types of benign ovarian tumours:
Fibromas Germ cell tumours Sex cord tumours Teratomas Functional cysts Endometriomas
When is it appropraite to use the Risk of Malignancy scoring system?
In post-menopausal women who have ?benign ovarian cysts / tumours
What are the three things seen inmeig’s syndrome?
Pleural effusion
Benign ovarian fibroma
Ascites
Is endometrial cancer more common in pre or post menopausal women?
Post menopausal
How does endometrial cancer tend to present?
Post menopausal vaginal bleeding
List some risk factors for endometrial cancer?
Tamoxifen therapy Obesity Nulliparity DM PCOS Anovulatory cycles Early menarche and late menopause HRT - unopposed oestrogen Estrogen secreting tumours elsewhere Endometrial hyperplasia Genetics e.g. lynch syndrome
Give two protective factors for endometrial carcinomas:
COCP
Multiparity
What is the first line investigation for endometrial carcinoma?
Transvaginal scan for endometrial thickness
>4mm is abnormal
95% of all endometrial cancers are _______?
Adenocarcinomas
What is one form of investigation in post menopausal bleeding which can be done as an outpatient?
Endometrial sampling
