prognosis Flashcards
HSV
high mortality rt
lichen sclerosis leukoplakia
incr risk SCC of vulva
VIN (vulvar intraepithelial neoplasia)
- spont regression
- progresses to invasive carcinoma in females > 45 yrs or immunocompromised. (basaloid and warty)
keratinizing scc of vulva
prognosis related to tumor size, depth of invasion and involvement of lymph vessels.
Lesions < 2cm = 90% 5 yr survival after tx with vulvectomy + ladectomy.
Larger lesions w involved LNs have worse prognosis
DES-related vaginal adenosis
can lead to clear cell carcinoma of vagina
extramammary paget dis
o May remain intraepidermal for yrs and not invade or metastasize.
o Invasion = poor prognosis.
Embryonal Rhabdomyosarcoma (sarcoma bortyoides)
-invade locally –> death via penetratio peritoneal cavity or obs urinary tract
neuroendocrine carcinoma of cervix
poor
carcinoma of cervix
oPts tend to die from consequences of local tumor invasion (ureteral obstruction, pyelonephritis, uremia).
o100% 5 yr survival for microinvasive carcinomas.
o< 50% 5 yr survival for tumors extending beyond the pelvis.
–50% are detected in females w/o regular screenings.
endometriosis with PTEN ARID1A
increased risk of ovarian and endometrioid and clear cell types
endometrial polyps
rarely give rise to adenocarcinoma, can be malig
nonatypical endomeriod hyperplasia
- if estrogen withdrawn –>cystic atrophy
- rarely progress to aenocarcinoma
-Type 2 endometrial serous carcinoma
- if bleeding, good bc usu catch early
- Propensity for extrauterine spread.
- 18-27% 5 yr survival even if confined to the uterus, 80% recurrence.
Types 1 and 2 endometrial carcinoma
-based on depth/stage at prsentaiton
-Stage I (grade 1 or 2): 90% 5 yr survival.
•–Tx w surgery +/- irradiation.
-Stage I (grade 3): 75% 5 yr survival.
-Stage II or III: < 50% 5 yr survival
Malignant Mixed Mullerian Tumors (MMMTS) (carcinosarcomas)
o Prognosis based on depth of invasion and stage.
o If tumor has a heterologous mesenchymal component = worse than those who do not.
o 25-30% 5 yr survival for high-stage dz.
Leiomyosarcoma
o 40% 5 yr survival.
o Anaplastic lesions: 10-15% 5 yr survival.
o Often recur after surgery
serous tumors of ovary (mullerian epithelium)
Prognosis and tx depend on pathologic classification as both low & high grade may extend to the peritoneum.
Borderline & malignant, confined to the ovary: 100% & 70% 5 yr survival.
Borderline & malignant, spread to the peritoneum: 90%, 25% 5 yr survival.
mucinous tumors of ovary (mullerian epithelium)
95% 5 yr survival for stage I, noninvasive.
90% 5 yr survival for invasive malignant tumors.
Fatal if spread beyond the ovary.
Pseudomyxoma Peritonei
intestinal obstruction and death if extensive
endometriod tumors of ovary (mullerian epithelium)
75% 5 yr survival (stage I).
clear cell carcinoma of ovary (mullerian epithelium)
90% 5 yr survival if confined to the ovaries.
Poor outcome if advanced
immature malignant teratoma of ovary
- Stage I, grade 1 = excellent prognosis.
- Prophylactic chemo if higher grade yet confined to the ovary.
- Recurrences occur in first 2 yrs.
- Longer absence = excellent chance of cure.
dysgerminoma of ovary
Excellent prognosis with salpingooophorectomy if seen only in the ovary.
80% survival in those extended beyond ovary
yolk sac tumor of ovary
80% survival with chemo regardless of dz stage.
granulosa cell tumor of ovary
85% 10 yr survival.
If predominantly composed of theca cells it is unlikely to be malignant.
gonadoblastoma
excellent if excised
complete mole
o 2.5% risk of choriocarcinoma.
o 15% risk of persistent or invasive mole.
partial mole
o ↑ risk of persistent molar dz.
o Not associated with choriocarcinoma
choriocarcinoma
o Evacuation of uterine contents + chemo.
o 100% remission and high cure rate.
o Cured pts can have subsequent normal pregnancies and deliveries
Placental Site Trophoblastic Tumor (PSTT)
- Localized dz = excellent prognosis.
* Dissminated dz = 10-15% mortality.
