Gynecologic Cancer Flashcards
Cervical Cancer Risk Factors
- Sexual activity
- HPV 16,18,31,33,35 subtypes.
- Cigarette smoking
- Immune system alterations
Cervical cancer treatment
- Depends on stage. disease bulk, patient characteristics and preference.
- Radical pelvic surgery if caught early.
- Radiation +/- chemotherapy
T/F: Surgery vs radiation therapy for stage I and IIA cervical cancer has equal cure rate?
True
Cervical cancer is predominately what histology?
Squamous cell
What is the most common female pelvic malignancy? Usually postmenopausal
Endometrial Cancer
Role of surgery for Endometrial cancer
- Definitive treatment
- Staging and nodal biopsies/ lymphadenectomy
- Control of pelvic disease and hemorrhage
Vulvar cancers are normally ________ cell cancers.
The presentation includes:
Squamous
-Itching, soreness, bleeding, lump or lesion.
Treatment of vulvar cancer
- Radical vulvectomy, bilateral inguinal/femoral lymphadenectomy
- Defines extent of disease (stage)
- Definitive treatment for most patients
DDX for an adnexal mass
Non-Gynecologic: Diverticulitis, Iletis, appendicitis, colon cancer, urologic
Gynecologic: Ovarian, uterine, fallopian tube, lymphatic, pregnancy, infectious
What 3 things can cause ovarian masses
- Functional cysts
- Endometriomas- Not cancerous, not functional
- Neoplastic
Acquired progressive dysmennorhea means…
Endometriosis
What things might be concerning with an adnexal mass leading toward diagnosis of cancer?
- Elevated CA-125, LDH, AFP, HCG
- Complex US findings
- Premenarchal
- Ascites
- Fixation
- Prior cancer diagnosis
Types of ovarian cancer
- Epithelial (most common)
- Germ cell
- Stromal carcinomas
- Metastatic
What presents with acute pain, commonly confused with an appy or ectopic pregnancy. Most frequently in late teens or early twenties. Chemo sensitive and almost always unilateral.
Ovarian Germ Cell Tumor- fertility concerns. Disgerminoma can be bilateral
What is the most common and benign ovarian germ cell tumors?
Dermoid
What are 4 malignant ovarian germ cell tumors?
1) Dysgerminoma
2) Immature teratoma
3) Endodermal sinus tumor
4) Embryonal carcinoma
3 Ovarian stromal benign tumors
Fibroma, thecoma, lydig cell
Malignant ovarian stromal tumor
- Granulosa cell (make estrogen)
- Sarcoma
Malignancies that commonly metastasize to the ovary are…
- Thyroid
- Breast
- Colon
- Cervical
What is the leading cause of death from gynecologic cancer?
-Epithelial ovarian cancer
Risk Factors of epithelial ovarian cancer
- Age- primarily postmenopausal
- Race: Caucasian>black
- Geography- european
- Reproduction
Signs and symptoms of ovarian cancer
Early: Usually no symptoms, incidental mass found
Late: Abdominal bloating, N/V, bladder and rectal symptoms
Surgery in Ovarian Cancer does what?
- Definitive diagnosis
- Determine extent of disease
- CYTOREDUCTION
- Second look laparotomy
- Palliation
Pre-op evaluation in ovarian cancer includes
- US
- Colonoscopy or BE
- CT scan
- Tumor markers
- CXR
- Mammogram
- Counseling
What in ovarian cancer is essential to rational treatment planning, prognostic, and therapeutic?
-Staging
Aggressive cytoreduction at primary surgery in ovarian cancer does what?
Improves long term survival
