Gynecologic Cancer Flashcards

1
Q

Cervical Cancer Risk Factors

A
  • Sexual activity
  • HPV 16,18,31,33,35 subtypes.
  • Cigarette smoking
  • Immune system alterations
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2
Q

Cervical cancer treatment

A
  • Depends on stage. disease bulk, patient characteristics and preference.
  • Radical pelvic surgery if caught early.
  • Radiation +/- chemotherapy
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3
Q

T/F: Surgery vs radiation therapy for stage I and IIA cervical cancer has equal cure rate?

A

True

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4
Q

Cervical cancer is predominately what histology?

A

Squamous cell

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5
Q

What is the most common female pelvic malignancy? Usually postmenopausal

A

Endometrial Cancer

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6
Q

Role of surgery for Endometrial cancer

A
  • Definitive treatment
  • Staging and nodal biopsies/ lymphadenectomy
  • Control of pelvic disease and hemorrhage
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7
Q

Vulvar cancers are normally ________ cell cancers.

The presentation includes:

A

Squamous

-Itching, soreness, bleeding, lump or lesion.

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8
Q

Treatment of vulvar cancer

A
  • Radical vulvectomy, bilateral inguinal/femoral lymphadenectomy
  • Defines extent of disease (stage)
  • Definitive treatment for most patients
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9
Q

DDX for an adnexal mass

A

Non-Gynecologic: Diverticulitis, Iletis, appendicitis, colon cancer, urologic
Gynecologic: Ovarian, uterine, fallopian tube, lymphatic, pregnancy, infectious

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10
Q

What 3 things can cause ovarian masses

A
  • Functional cysts
  • Endometriomas- Not cancerous, not functional
  • Neoplastic
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11
Q

Acquired progressive dysmennorhea means…

A

Endometriosis

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12
Q

What things might be concerning with an adnexal mass leading toward diagnosis of cancer?

A
  • Elevated CA-125, LDH, AFP, HCG
  • Complex US findings
  • Premenarchal
  • Ascites
  • Fixation
  • Prior cancer diagnosis
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13
Q

Types of ovarian cancer

A
  • Epithelial (most common)
  • Germ cell
  • Stromal carcinomas
  • Metastatic
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14
Q

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.

A

Ovarian Germ Cell Tumor- fertility concerns. Disgerminoma can be bilateral

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15
Q

What is the most common and benign ovarian germ cell tumors?

A

Dermoid

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16
Q

What are 4 malignant ovarian germ cell tumors?

A

1) Dysgerminoma
2) Immature teratoma
3) Endodermal sinus tumor
4) Embryonal carcinoma

17
Q

3 Ovarian stromal benign tumors

A

Fibroma, thecoma, lydig cell

18
Q

Malignant ovarian stromal tumor

A
  • Granulosa cell (make estrogen)

- Sarcoma

19
Q

Malignancies that commonly metastasize to the ovary are…

A
  • Thyroid
  • Breast
  • Colon
  • Cervical
20
Q

What is the leading cause of death from gynecologic cancer?

A

-Epithelial ovarian cancer

21
Q

Risk Factors of epithelial ovarian cancer

A
  • Age- primarily postmenopausal
  • Race: Caucasian>black
  • Geography- european
  • Reproduction
22
Q

Signs and symptoms of ovarian cancer

A

Early: Usually no symptoms, incidental mass found
Late: Abdominal bloating, N/V, bladder and rectal symptoms

23
Q

Surgery in Ovarian Cancer does what?

A
  • Definitive diagnosis
  • Determine extent of disease
  • CYTOREDUCTION
  • Second look laparotomy
  • Palliation
24
Q

Pre-op evaluation in ovarian cancer includes

A
  • US
  • Colonoscopy or BE
  • CT scan
  • Tumor markers
  • CXR
  • Mammogram
  • Counseling
25
Q

What in ovarian cancer is essential to rational treatment planning, prognostic, and therapeutic?

A

-Staging

26
Q

Aggressive cytoreduction at primary surgery in ovarian cancer does what?

A

Improves long term survival