Repro 12: Gynaelogical Tumours Flashcards
Which types of HPV can predispose to cervical carcinoma/ CIN?
16 and 18
Where in the cervix is most vulnerable to carcinoma/ HPV infection?
Transformation zone
What does cervical screening involve?
From age 25 to 50 every 3 years
Then every 5 years from 50 to 65
Cells from the transformation zone are scraped off and Pap stained and examined microscopically
What are the majority of invasive cervical carcinomas?
80% squamous cell carcinomas
15% adenocarcinoma
How can invasive cervical carcinoma be treated?
Cervical cone excision Hysterectomy Lymph node dissection Chemotherapy Radiotherapy
What age group does endometrial adenocarcinoma usually affect?
Older women, peri menopausal
What is endometrial adenocarcinoma?
Usually presents with irregular post menopausal bleeding
Associated with unopposed oestrogen (obese, late menopause and early menarche, oestrogen secreting tumour)
Can spread to myometrium and other tissues
What is a benign tumour in the myometrium?
Leiomyoma aka fibroid
How can leiomyomas present?
Can be asymptomatic or cause heavy/ painful periods, urinary frequency and bladder compression
Oestrogen dependent so often regress after menopause
What age category do ovarian carcinomas usually affect?
Most are benign, affecting young women (age 20-45)
Some malignant tumours generally affect older women (age 45-60)
How do ovarian carcinomas generally present?
Have few symptoms, so often present late by which time they have already spread beyond the ovary, so have a poor prognosis
Some are associated with BRCA mutations
What serum marker can be used for ovarian carcinoma diagnosis?
CA-125
What is the most common germ cell tumour of the ovaries?
Benign cystic teratoma aka dermoid cyst
What is a benign cystic teratoma?
Usually benign, germ cell tumour of the ovary
Usually in young women
Contain hair, teeth and sebaceous material
What is struma ovarii?
Monodermal (= highly specialised) ovarian teratoma
Benign
Composed entirely of mature thyroid tissue
Capable of causing hyperthyroidism
What are ovarian sex cord stromal tumours?
Can resemble Sertoli/Leydig cells or granulosa and theca cells
Therefore can be masculinising or feminising depending on the cells they form
Which type of ovarian tumour is capable of causing precious puberty in pre-pubertal women?
Ovarian sex cord stromal tumour
(If it forms granulosa and theca cells it can be feminising. In adult women this would lead to endometrial hyperplasia/ breast disease/ endometrial carcinoma)
What is VIN?
= vulval intra epithelial neoplasia
Collection of atypical squamous cells within the epidermis (no invasion)
In situ pre cursor to vulval squamous cell carcinoma
Associated with HPV 16 and 18
Which type of carcinoma usually affects the vulva?
Squamous cell carcinoma
But they are uncommon
How do vulval carcinomas present?
Warty lesions
Often spread locally and can metastases to lymph
What are two gynaecological tumours of gestation?
Hydratidiform mole and choriocarcinoma
What is a hydatidiform mole?
When a non viable egg implants in the uterus and will fail to come to term
Causes oedema of placenta, chorionic villi
Friable mass of transducer grape like structures
Associated with choriocarcinoma
What is choriocarcinoma?
Malignant tumour of trophoblast of cells
No villi present!
Metastasises widely but responds well to chemotherapy
Usually presents with vaginal spotting and high hCG levels
