Pathological conference of Uterus Flashcards
What are the important aspects of taking a history from a woman suffering with post menopausal bleeding?
1) When was your LMP? Regularity of menstrual cycle
2) What colour is the blood?
3) Any other associated symptoms - abdominal/pelvic pain, urinary or bowel symptoms
4) Did you take HRT during menopause?
5) BMI
6) Smoking and alcohol history
7) PMH
8) Last cervical screening
What investigations should be performed for a patient with post-menopausal bleeding?
1) Transvaginal USS - will measure endometrial thickness
2) Pelvic and Speculum examination
3) Hysteroscopy
What are the principles of management of a patient with endometrial cancer?
Early stage - Total Abdominal Hysterectomy (TAH), Bilateral Salpingoophorectomy (BSA)
High risk histology - Chemo
Advanced stage - radiotherapy
Palliation - progesterone
What are the symptoms of endometrial cancer?
1 - Abnormal vaginal bleeding
2 - Post-menopausal bleeding
What are the 2 different types of endometrial cancer?
Type 1:
- Endometrioid Adenocarcinoma
- The most common type
- Caused by unopossed oestrogen
- Hyperplasia of endometrial tissue
Type 2:
- Uterine serous & clear cell carcinoma
- High grade, more aggressive and worse prognosis
- Generally older ladies
What are the different stages of endometrial cancer and what is the staging system called?
Staging system - FIGO 2009
1A - Inner half of myometrium
1B - Outer half of myometrium
2 - Invades cervix
3A - Serosa/adnexa
3B - Vagina/parametrium
3C - Pelvic or para-aortic nodes
4 - Bladder/bowel/intra-abdominal/inguinal nodes
What investigation techniques are used to stage endometrial cancer?
1 - MRI
2 - Surgical
3 - Pathological
What are the avergae 5YS rates for all stages of endometrial cancer and specifically for stage 1 and stage 4?
All stages - 78%
Stage 1 - 95%
Stage 4 - 14%
