PATH - Cervical Cancers

Question 1

Choriocarcinoma

Answer 1

Rare

can develop during or after pregnancy in mother or baby.

Malignancy of trophoblastic tissue (cytotrophoblasts, syncytiotrophoblasts)

*no chorionic villi present

Presents with abnormal INC β-hCG, shortness of breath, hemoptysis

Hematogenous spread to lungs.

INC frequency of bilateral/
multiple theca-lutein cysts

Question 2

Squamous cell

carcinoma (SCC) of vagina

Answer 2

Usually 2° to cervical SCC

1° vaginal carcinoma rare

Question 3

Clear cell adenocarcinoma of vagina

Answer 3

Affects women who had exposure to *DES in utero

Question 4

Sarcoma botryoides
(embryonal rhabdomyosarcoma
variant)

Answer 4

Affects girls

Question 5

Dysplasia and carcinoma in situ of cervix

Answer 5

Disordered epithelial growth

begins at basal layer of squamocolumnar junction (transformation zone) and extends outward

Associated with:
HPV 16 - E6 gene product (inhibits p53 suppressor gene)
HPV 18 - E7 gene product (inhibits RB suppressor gene)

Typically asymptomatic or presents as *abnormal vaginal bleeding (often *postcoital)

RISK
multiple sexual partners (#1), smoking, starting sexual intercourse at young age, HIV
infection.

Question 6

Invasive carcinoma of cervix

Answer 6

Often *squamous cell carcinoma.

Pap smear can catch cervical dysplasia (koilocytes) before it progresses to invasive carcinoma.

Diagnose via colposcopy and biopsy.

Lateral invasion can block
ureters–>renal failure