Gynecological Oncology Lecture Powepoint Flashcards
This is a shit one
Dysplasia
Disorders of cellular growth and development, may result from abnormal cell size, number, or differentiation
Neoplasia
Process of accelerated or uninhibited division and growth of abnormal cells
Hyperplasia
An increase in number of cells, usually an adaptive response to demans for increased tissue function
Benign characteristics
-well differentiated, slow growth, localized, noninvasive, defined margins
Malignant characteristics
Poorly differentiated, fast growth, invasive spread, margins not clear
Carcinoma
A cancer of epithelial cell origin
Sarcoma
A cancer of connective tissue origin
Doubling time of a tumor determines….
….how aggressive it is
Direct spread
Invasion of cancer into surrounding tissues, lack of demarcated borders
Metastasis
Invasion of cancer into vessels or lymphatics
TNM classification
Varies with different types of cancers and how far they are developed, as well as how they are treated and their prognosis, T standing for size (0-4) N for number of regional lymph nodes involved (0-4) and M0 for abscence of metastatis or M1 for presence of it
Most common causes of vulvar, cervical, and vaginal cancer
HPV subtypes 16 and 18
VIN
Vulvar intraepithelial neoplasia, classified by depth and epithelial cell maturation, with I being mild and III being severe dysplasia
Paget’s disease
Vulvar skin disease most often seen in post menopausal white women, treated with surgical removal
Cancer of the vulva is most often what type?
Squamous cell carcinoma
1/3 of patients with vulvar cancer will also have…
….A 2nd malignancy usually cervical or vaginal
When you find VIN or paget’s disease you should look for….
…additional cancers of the vagina, cervix, or uterus
Paget’s disease with nodal involvement
Invariably fatal presentaiton
Paget’s disease of the breast
A rare form of breast cancer that starts on the nipple and extends to the areola, related to paget’s disease of the vulva
Key to surviving cancer of the vulva
Early detection and treatment
Most common vaginal cancer
Cervical cancer extension into adjacent vaginal tissue
Best time to diagnose vaginal cancer
Looking at vaginal mucosa when moving or removing speculum
Treatment for vaginal cancer
Surgery or radiation, chemo is not effective
Gravida/parity/abortus
Times been pregnant/times given live birth/lost pregnancies
Cervical cancer treatment even in early stages includes…
…hysterectomy
Most common gynecologic malignancy
Endometrial cancer
Triad risk factors for endometrial cancer
Obesity, hypertension, diabetes mellitus
Other endometrial cancer risk factors (5)
- PCOS
- exogenous estrogen
- nulliparity
- multiple endocrine neoplasia syndrome
- tamoxifen
Endometrial cancer number 1 symptom
Abnormal uterine bleeding
Any menopausal or postmenopausal paatient with abnormal bleeding must be evaluated for….
…endometrial cancer
Endometrial cancer diagnosis (also, what specific thing do you never do for this)
Biopsy (never a pap smear)
Tumor marker in endometrial cancer or ovarian cancer
CA 125
Endometrial cancer treatment (both standard and non standard of care)
- Hysterectomy and bilateral salpingo-oophorectomy is standard
- Progestational agents to produce antitumor response is nonstandard but preserves fertility
Common uterine sarcoma presentation
Usually after 40 yrs, rapid enlargement of uterus or a leiomyoma
Ovarian cancer risk factors
Low parity and family history
2 preventative measures against ovarian cancer
Multiple pregnancies or oral contraceptives
2 syndromes associated with ovarian cancer
- Lynch II
- Breast ovarian cancer syndrome
Primary mode of dissemination of ovarian cancer
Implantation on peritoneal surfaces
Ovarian cancer is often ____ until it has already progressed into stage III or IV
Asymptomatic
Sister Mary Joseph’s nodule
Metastatic implant in the umbilicus and a screeing test for ovarian cancer
Ovarian cancer diagnosis
Ultrasound imaging (often false positives) followed by diagnostic laporoscopy
Elevated CA-125 cannot ___ a patient with ovarian cancer, it is only ___
diagnose definitively, supplemental
BRCA 1 and 2 mutations
Associated with increased rates of breast, ovarian, and prostate cancer
