Repro Cancers Flashcards
Invasive cervical carcinoma
often squamous cell carcinoma
Pap smear can detect cervical dysplasia (koilocytes) before it progresses to invasive carcinoma
Lateral invasion can block ureters causing renal failure (hydronephrosis)-cause of death
Presents as poitcoital vaginal bleeding
Cervical Dysplasia and carcinoma in situ
Disordered epithelial growth
Begins at basal layer of sqaumocolumnar junction (transition zone)
Classification:
CIN I involves less than 1/3 the thickness of epithelium
CINII involves less than 2/3 the thickness of epithelium
CIN III involves slightly less than the full thickness of the epithelium
Associated with HPV 16 and 18 which produce E6 (p53 inhibitor) and E7 (RB suppressor)
May progress to invasive carcinoma
Typically asymptomatic (detected on Pap smear) or presents as abnormal vaginal bleeding (postcoital)
Risk factors: multiple sex partners, smoking, early sexual intercourse, HIV
Adenomyoma of uterus
Well circumscribed collection of endometrial tissue within the uteruine wall
may contain smooth muscle cells
Can extend into the endometrial cavity in the form of a polyp
Presents as abnormal uterine bleeding
Side effect of tamoxifen
Endometrial hyperplasia
Abnormal endometrial gland hyperplasia usually caused by excess estrogen stimuation
increased risk of endometrial carcinoma-dependent upon amount of atypia not hyperplasia
Manifests as postmenopausal bleeding
Risk factors: anovulatory cycles, hormone replacement therapy, polycystic ovarian syndrome and ganulosa cell tumor
Endometrial carcinoma
Most common gyneocologic malignancy
Peak occurrence at 55-65 years old
Clinically presents with vaginal bleeding (postmenopausal)
Typically preceded by endometrial hyperplasia
Sporadic pathway: atrophic endometrium with papillary structures-psammoma body formation-p53 mutation (aggressive)
Risk factors: use of estrogen without progestins, obesity, diabetes, hypertension, nulliparity, and late menopause
Incraesed myometrial invasion decreases prognosis
Leiomyoma
Benign neoplastic proliferation of smooth muscle arising from mometrium
Most common tumor in females
Related to estrogen exposure: common in postmenopausal women, often mutiple
Enlarge during pregnancy, shrink during menopause
Gross: multiple, well-defined, white, whorled masses that may distort the uterus and impinge on pelvic structures
Usually asymptomatic but can present with abnormal uterine bleeding, infertility and pelvic mass (may have iron deficiency anemia)
Serous Cystadenoma
Benign ovarian neoplasm
Most common
Thin-walled uni-or multilocular
Line with fallopian like epithelium
Often bilateral
Mucinous cystadenoma
benign ovarian neoplasm
Multiloculated large
Lined by mucus secreting epithelum
Endometrioma
Benign ovarian neoplasm
Mass arising form ectopic endometrial tissue
Copmlex mass on ultrasoun
Presents with pelvic pain, dysmenorrhea, dysparenunia
teratoma
Mature cystic Germ cell tumor-benign ovarian neoplasm
Can contain elements from all 3 germ layers: teeth, hair, sebum, are common components
Can present with pain secondary to ovarian enlargment or torsion
Can also contain functional thyroid tissue (specific for mature)and present as hyperthyroidism
Immature teratoma is aggressive
Contains fetal tissue, neuroectoderm (specific for immature)
Brenner tumor
Benign ovarian neoplasm
Looks like bladder
Solid tumor that is pale yellow tan in color and appears encapsulated
Coffee-bean nuclei on H and E stain
Fibromas
Benign ovarian neoplasm
Bundles of spindle shaped fibroblasts
Meigs syndrom: triad of ovarian fibroma, ascites and hydrothorax
Pulling sensation in groin
Thecoma
Benign ovarian neoplasm
May produce estrogen
Present as abnormal uterine bleeding in a postmenopausal women
Granulosa cell tumor
Most common sex cord stromal tumor
Predominantly in women in their 50s
Often produce estrogen and progesterone
Leads to uterine bleeding, precocious puberty, breast tenderness
Endometrial hyperlasia (endometrial carcinoma)
Histology show Call-Exner bodies (eosinophilic excretions)
Serous Cystadenocarcinoma
Most common ovarian neoplasm
Frequently bilateral
Psammoma bodies
Mucinous Cystadenocarcinoma
Psuedomyxoma peritonei-intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor
Dysgerminoma
Most common in adolescents
large cells with clear cytoplasm and central nuclei (fried eggs)
(testicular counterpart is seminoma)
LDH may be elevated
Choriocarcinoma
Can develop during or after pregnancy in mother or baby
Also in males
Malignancy of trophoblastic tissue (cytotrophoblasts and syncytiotrophoblasts)
NO chorionic villi present
Increased frequency of theca-lutein cysts
Abnormal B-hCG, shortness of breath, hemoptysis (hematogenous spread to lungs)
May produce gynecomastia or hyperthyroidism (HCG has TSH and LH analog abilities)
Very responsive to chemo
Yolk sac tumor (endodermal sinus)
Agressive in ovaries and testes and scarococcygeal area in young children
Most common tumor of male infants
Yellow, friable (hemorrhagic) soild mass
Shiller Duval bodes (glomeruli-like)
AFP positie
Krukenberg tumor
GI malignancy that metastasizes to ovaries causing a mucin secreting signet cell adenocarcinoma
Vaginal Clear Cell Carcinoma
Malignant proliferation of glands with clear cytoplasm
rare but feared complication of DES associated vaginal adenosis
Embryonal rhabdomyosarcoma (sarcoma botryoides) of the vagina
Malignant mesenchymal proliferation of immature skeletal muscle
Prsents as bleeding and a grape like mass protruding from vagina or penis of a child less than 5 years old
Rhabdomyoblast exhibits cytoplasmic cross striations and positive immunohistochemical staining for desmin and myogenin
Vaginal carcinoma
Sqamous epithelium lining the vagina mucosa
usually related to HPV
Precursor si vaginal intraepithelial neoplasia
lower 1/3 goes to superficial inguinal
Upper 2/3 goes to regional external iliac, hypogastric, obturator
Fibroadenoma
Characteristics: small, mobile mass with sharp edges
Myxoid stroma that encircles epithelium lined glandular and cystic spaces
epithelium compressed by surrounding stroma
Increase in size and tenderness with increased estrogen (pregnancy, prior to menstruation)
