Malignancy: Uterus Flashcards

1
Q

Adenosarcoma

A

Tumor of mixed origin. Epithelial component composed of benign glands; only the mesenchymal portion is malignant

Can have sarcomatous overgrowth; more aggressive with metastatic potential

Less aggressive than MMMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Endometrial stromal sarcoma

A

2 types: low-grade and high grade (undiff). Composed of oblong, round or spindled cells only. No epithelial component.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Endometrial adenocarcinoma

A

Histologic grade is an important predictor of both the depth of invasion and regional LN mets.

Grade 1: <5% solid component (non-squamous)
Grade 2: 5 to 50% of solid component
Grade 3: >50% solid component

Nuclear atypia may upgrade.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Serous and clear cell carcinoma

A

High grade by definition due to poor prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Secretory carcinoma

A

Low grade with excellent clinical outcomes (grade 1 always)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Arias Stella rxn

A

-either currently pregnant or recently pregnant. Not indication of whether intrauterine or ectopic

DDx: Clear cell carcinoma (most likely in post-menopausal woman)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Low grade endometrial stromal sarcoma vs endometrial stromal nodule

A

Deep myometrial invasion in former (tongues of spindle cells infiltrating into the myometrium) and vascular invasion

Hysterectomy needed to make distinction

+ CD10; neg desmin amd h-caldesmon

[smooth muscle tumors usually CD10 neg; pos desmin and h-caldesmon]
DDx: cellular leiomyoma, intravenous leiomyomatosis, leiomyosarcoma, adenosarcoma, MMMT, PEComa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Leiomyosarcoma

A

Coagulative necrosis is the most important factor in determining malignancy

In absence of necrosis, mitosis > 10 mits/10 hpf is needed with diffuse moderate to severe atypia

High mitotic rate alone or pleomorphism alone or increased cellularity alone are all insufficient to make diagnosis

Usually single (vs leiomyomas are often multiple)
Leoprolide admin can have necrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Carcinosarcoma or malignant mixed mullerian tumor

A

elderly, post-menopausal women

Large, bulky, polypoid lesion; may prolapse into vagina

Epithelial and mesenchymal elements with deep myometrial invasion

2 types: homologous and heterologous
Difference in origin of stroma: homologous > endometrial stroma; heterologous > bone, catrilage, fat

epithelial component: usually glandular, but can be squamous or undifferentiated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Risk factors for poor prognosis in endometrioid endometrial adenocarcinoma

A
Increased Ki-67
Low p21 levels
Microsatellite instability
high survivin expression
Increased p53 activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly