Lecture 71 - Clinical Aspects of Gyn Malignancies Flashcards
60 yo obese female presents with post menopausal bleeding, menorrhagic, blood discharge: you should immediately be thinking…
Endometrial Cancer
most common type of which is endometriod carcinoma
30 yo female presenting with Post Coital Bleeding, intermittent spotting and vaginal discharge. … what should you be thinking ?
Cervical SCC
what is the most common stage of presentation for women with ovarian cancer?
what type of symptoms do they present with?
Stage IIIC
Presenting with vague symptoms; usually abdominal in nature due to spread to peritoneum
gardasil protects patients against which forms of HPV?
6, 11, 16, 18
How does invasive Cervical cancer spread ?
How is it staged?
Treatment of invasive cervical cancer ?
spreads Locally;
staged Clinically – H&P, Colcopscopy, CXR (for distant mets)
Surgery and radiation
Chemorads for advanced stages
Chemo for palliation
what is the most common malignacny of the female genital tract ?
what is the female GU malignacy with the highest mortlaity ?
Endometrial cancer
mortality: Ovarian cancer
How is endometrial cancer staged ?
common stage at presentation?
How does endometrial cancer spread ?
treatment of endometrial cancer: low vs high grade
Surgical staging: laproscopy
Stage at presentation: Stage 1
Spread: Lymphatics
Treatment:
Low grade: hysterectomy
High grade: + adjuvant therapies
If a <40 yo presents with endometrial Hyperplasia, the go to therapy would be a hysterectomy, however what other options are available if she would still like to be able to conceive?
High dose progesterone (bc endometrioid tumors are in light unopposed estrogen), may be able to put the tumor in remission
Three categories of ovarian cancers:
Surface epithelial (serosa)
Sex cord/Stromal (Granulosa-theca)
Germ Cell (teratoma, germinoma, yolk sac)
HNPCC is a rare cause of what types of female GU cancers
ovarian and endometrial
what serum marker can be used to help diagnose ovarian cancer
CA 125
Common presenting sympotms of ovarian cancer
findings upon CT
Bloating
Abd pain
Ascites and Free Fluid, caking (eg tumors on the omentum)
spread of ovarian cancer
stage at presentation
Peritoneal spread
Stage IIIC
how is ovarian cancer staged?
what is the first step in treatment ?
Surgically staged
Treatment: Debulking surgery;
how do patients of ovarian cancer typically die?
die from bowel obstruction and malnutrition
