Lecture 6 - Gyn Cancer

Question 1

gyn cancer:
which is most common?

which causes the most deaths?

Answer 1

endometrial;

ovarian

Question 2

which HPV subtypes cause cervical cancer?

E6 gene product inhibits ____;
E7 gene product inhibits _____

Answer 2

HPV 16, 18 (also 31, 33);

p53;
Rb

Question 3

cervical cancer typically presents as abnormal ____ ____, especially _____

Answer 3

vaginal bleeding, post-coital

typically no pain until advanced diseas

Question 4

Cervical cancer:

besides HPV, name 2 high yield risk factors

Answer 4

smoking, immunosuppression (ie HIV);

also multiple secx partners

Question 5

cervical cancer:
usually adenocarcinom or squamous cell?
lymph drainage to _____;
common cause of death?

Answer 5

squamous cell;
internal/external illiac (both on FA);

renal failure from hydronephrosis/ureter block

Question 6

enodometrial cancer:
strongly associated with _____;
increased risk with ____parity, ____ menopause, _____ menarche

Answer 6

unopposed estrogen;

nulliparity, late, early

Question 7

endometrial cancer:

the ____ pathway is associated with estrogen exposure. seen in (younger or older) women? _____ on histology

Answer 7

hyperplasia;
younger ie 50’s;
endometrioid (ie adenocarcinoma)

Question 8

endometrial cancer:
the sporadic pathway is associated with _____ endometrium. associated with ____ mutations and is seen in _____ women. _____ on histology. aggressive or no?

Answer 8

atrophic;
p53; 
older (70s);
papillary/serous (also with psammoma bodies);
aggressive AF

Question 9

uterine sarcomas:
benign or aggressive?
prior ____ is possible risk factor

Answer 9

aggressive;

pelvic radiation

Question 10

complete vs partial mole:
46 chromes = 
69 chromes = 
fetal parts = 
no normal villi =

Answer 10

complete;
partial;
partial;
complete

Question 11

complete vs partial mole:
“snowstorm” on ultrasound =
low risk of progression to choriocarcinoma/cancer =
P57+ =

for both, monitor ____-

Answer 11

complete;
partial;
partial;

bHCG

Question 12

choriocarcinoma:
NO ____ present;
hematogenous spread to _____;
good response to chemo if its a complication of _____

Answer 12

chorionic villi (ie only trophs);
lungs –> cannonballs;
gestation (vs germ cell)

Question 13

ovarian cancer–
risk increases or decreases with….

infertility =
previous pregnancy =
OCPs =

Answer 13

increased risk
decreased;
decreased

Question 14

ovarian cancer:
most cancers are of what type?
what gene is associated with this cancer

Answer 14

epithelial;

BRCA1,2

Question 15

ovarian cancer:

monitory response to therapy with ____ levels;

Answer 15

CA-125

Question 16

ovarian cancer: high yields associated with what type?

urothelium/transitional epithelium present = ____ tumor;
meigs syndrome =
call exner bodies and increased estrogen =

Answer 16

brenner;
fibroma;
granulosa cell tumor

Question 17

ovarian cancer: high yields associated with what type?

reinke crystals and androgens =
schiller-duval bodies and increased AFP =
increased HCG and LDH =

Answer 17

sertoli-leydig cell;
yolk-sac endodermal sinus;
dysgerminoma

Question 18

Vulvar carcinoma:
most are adeno or squamous cell carcinoma?
HPV related form (serotypes ___ and ____) is associated with younger or older women?

Answer 18

SCC;

HPV 16, 18 –> younger women (ie 40s to 50s)

Question 19

vulvar carcinoma:

non HPV form is associated with long standing _____. see in younger or older women?

Answer 19

lichen sclerosis;

older (ie elderly)

Question 20

vulva drains lymph to _____;
where does the proximal vagina drain to?
what about distal vagina?

Answer 20

superficial inguinal;
proximal vagina = internal illiac;
distal = superficial inguinal

Question 21

vaginal cancer:

SCC is usually primary or from cervical mets?

Answer 21

cervical mets

Question 22

exposure to DES in utero causes what cancer?

what is its precursor lesion?

Answer 22

vaginal clear cell carcinoma;

adenosis