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Gynaecological Cancer Flashcards

1
Q

What is the most common pelvic mass?

A

Pregnancy

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2
Q

What is the most common uterine mass?

A

Fibroid

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3
Q

What is the most common ovarian mass?

A

Ovarian cyst

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4
Q

What is the most common symptom of cervical cancer?

A

Post-coital bleeding and/or intermenstrual bleeding.

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5
Q

What are non-gynaecological causes of pelvic mass?

A

Urinary distension
Bowel tumours
Appendicular abscess

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6
Q

What triad is involved in Meig’s syndrome?

A

Benign ovarian mass (usually a fibroma)
Ascites
Pleural effusion

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7
Q

What does a new onset IBS in an individual over 50 raise suspicion of?

A

Ovarian cancer

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8
Q

What must always be rule out in a woman of childbearing age that presents with a pelvic mass?

A

Pregnancy

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9
Q

What investigations are carried out in the context of an ovarian mass?

A 
Tumour markers
USS
MRI (if premenopause)
CT (if postmenopause)
Urine pregnancy test
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10
Q

What marker is elevated in ovarian cancer?

A

Ca-125

Not always true, use to aid diagnosis.

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11
Q

Is the CEA marker detectable in adults?

A

No, only elevated in the context of ovarian cancer.

May also appear in other conditions too (non-specific).

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12
Q

What does a Ca-125 :CEA ratio of <25 suggest?

A

Ovarian metastases

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13
Q

When is AFP raised?

A

Embryonal carcinoma if less than 40.

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14
Q

When is HCG raised?

A

Choriocarcinoma if less than 40.

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15
Q

When is LDH raised?

A

Dysgerminoma if less than 40.

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16
Q

In which age group are germ cell tumours most common?

A

Under 40yo

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17
Q

What are the most common type of benign ovarian mass?

A

Functional cysts

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18
Q

How do functional cysts present?

A

Sharp iliac-fossa pain.

Usually less than 5cm, and will resolve spontaneously.

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19
Q

What are ‘chocolate’ cysts characteristic of?

A

Endometriosis

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20
Q

How does endometriosis present?

A

Chocolate cysts
Severe dysmenorrhoea
Pain
Deep dypareunia

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21
Q

Does endometriosis affect fertility?

A

Yes - these patients are sub-fertile.

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22
Q

What is dypareunia?

A

A persistent or recurrent genital pain experienced before, during or after intercourse.

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23
Q

How are the ‘chocolate cysts’ of endometriosis formed?

A

In endometriosis, cells of the ovary develop resembling the womb - these bleed during menstruation too.

Accumulation of this blood leads to the ‘chocolate’ appearance.

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24
Q

Where is tenderness felt in endometriosis?

A

Behind the uterus.

Caused by attachment of the ovaries together in the pouch of Douglas.

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25
Which age group are benign ovarian masses most commonly seen in?
Young females
26
What benign mass can produce teeth, hair,sebaceous material or thyroid tissue within the ovaries?
Dermoid cysts.
27
How are benign ovarian masses treated?
OC pill GnRH agonists Surgery
28
What is a common presentation of ovarian cancer?
Ascites
29
How is ovarian cancer treated?
Chemotherapy and surgery
30
What is the most common form of ovarian cancer?
Germ cell tumour
31
What is neoadjuvant chemotherapy?
Chemotherapy which is given prior to surgery with the aim of shrinking a tumour, increasing the chance of a surgery being successful.
32
What is adjuvant chemotherapy?
Chemotherapy given after surgery aimed at killing any remnant cancer cells missed by surgery.
33
What is the main cause of cervical cancer?
HPV
34
What age group receive smear tests?
25-65 year olds.
35
How regularly are smear tests carried out normally?
Every 5 years
36
Is sex a risk factor for cervical cancer?
Yes - it is the only way HPV can be contracted. If no sex occurs, there is no risk.
37
What are the 2 forms of cervical cancer treatment?
Cold coagulation | Lietz
38
What is the most common form of gynaecological cancer?
Uterine cancer
39
What encompasses a hysterectomy?
Removal of the uterus and cervix.
40
How is vulval cancer treated?
Wide local excision (1cm margin)
41
What are pathological causes of uterine bleeding?
Polyps Endometriosis Adenomyosis Leiomyomata
42
Is endometrial hyperplasia a premalignant state?
No, unless it is the atypical subtype - then yes.
43
What age group is most commonly affected by endometrial carcinoma?
50-60 year olds.
44
What can predispose to endometrial cancer in young patients?
PCOS | Lynch syndrome
45
What does atypical hyperplasia precede?
Endometrioid carcinoma
46
What does serous intraepithelial carcinoma precede?
Serous carcinoma
47
How does endometrial carcinoma commonly present?
Abnormal bleeding usually sporadic/continuous bleeding post-menopause OR Intermenstrual bleeding in those of reproductive age.
48
What are the 2 subtypes of endometrial cancer?
Endometrioid carcinoma | Serous carcinoma
49
Which form of endometrial carcinoma is associated with unopposed oestrogen?
Endometrioid carcinoma
50
What is lynch syndrome?
An autosomal dominant disease caused by inheritance of a defective mismatch repair gene.
51
What is normally the cause of serous carcinoma of the endometrium?
p53 mutation
52
What is prognosis of an endometrial carcinoma dependent on?
Staging Histological grade (in cases of endometrioid only) Depth of myometrial invasion
53
What are fibroids associated with?
Heavy, prolonged, painful periods. May also cause infertility.
54
What are the malignant tumours of the myometrium called?
Leiomyosarcomas
55
What condition do follicular cysts develop in?
PCOS
56
What is endometriosis?
The presence of endometrial gland and stroma outwith the uterine body.
57
How is ovarian cancer usually diagnosed?
Sampling of ascitic fluid.
58
What is the presence of embryonic elements within a germ cell tumour called?
An immature teratoma
59
What must be ruled out in a woman of reproductive age presenting with amenorrhoea and an acute abdomen?
Ectopic pregnancy
60
What is the most common site for an ectopic pregnancy?
Fallopian tube
61
How is cervical cancer treated?
Radical surgery. In advanced disease, radical chemotherapy and radiotherapy may be given.
62
What % of oropharyngeal tumours are linked to HPV?
80% | Linked to oral sex.
63
What are risk factors for HOV-related cancer?
Smoking Early age onset intercourse High risk male Multiple partners
64
What is brachytherapy?
Insertion of internal radiotherapy to target the area in question. Used in cervical cancer treatment.
65
What is the main method of endometrial cancer treatment?
Surgery
66
What are risk factors for endometrial cancer?
Obesity HRT/Tamoxifen HNPCC gene carriage
67
How does endometrial cancer present?
Post-menopausal bleeding
68
An anterior pelvic mass is usually linked to what?
The bladder
69
A posterior pelvic mass is usually linked to what?
The uterus
70
What is the most common form of sex cord tumour?
A fibroma

Reproductive (28 decks)

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