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Semester 4 - Reproductive System > Session 12 - Cancers of the Reproductive System > Flashcards

Session 12 - Cancers of the Reproductive System Flashcards

1
Q

Name six places gynaecological tumours can effect

A
  • Vulva
  • Cervix (neck of uterus)
  • Endometrium (lining of uterus)
  • Myometrium (body of uterus)
  • Ovary
  • Tumours of gestation (pregnancy)
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2
Q

What are the most common type of cervical carcinomas?

A

Squamous carcinoma

Adenocarcinoma

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3
Q

Give five risk factors for cervical carcinoma

A

 Sexual intercourse, multiple partners
 Immunosuppression
 Cigarette smoking
 Long term use of the oral contraceptive
pill (OCP)
 Early first pregnancy and increasing risk
with each subsequent pregnancy

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4
Q

What is one of the viral causative agents of cervical carcinoma?

A

Human papilloma virus

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5
Q

Give three macroscopic features of squamous carcinoma cervix

A

Cervical expansion
Ulceration
Nodules

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6
Q

Give a main symptom of squamous cervix carcinoma

A

Post coital, intermenstrual or postmenopausal bleeding

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7
Q

Give three histological features of a squamous cervix carcinoma

A

Inflitrating tongues of squamous epithelium
Cytological geatures of malignancy (pleomorphism etc)
Variable differntitation

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8
Q

Where is the local spread of cervical cancer?

A

Ureters, rectum
Forms fistula
Lymphatic (paraortic)

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9
Q

How does cervical screening work?

A

Exfoliation of epidermal layer of cervix

Cervical cancer is full thickness abnormal dysplasia

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10
Q

What is cervical cancer graded on?

A

Mitotic activity
Nuclear pleomorphism, hyper chromasia (dark nucleus)
Nuclear/cytoplasmic ratio

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11
Q

Outline cerivcal screening, epidemiological

A

Start age 25th birthday

Every 3 years until 50

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12
Q

What if someone is HPV positive?

A

Followed up in usual way with calposcopy

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13
Q

What if someone is HPV negative?

A

Returned to screening programme

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14
Q

What are the two types of endometrial adenocarcinoma?

A

Type 1 - Unopposed oestrogen tumour

Type 2 - Clear cell and uterine serous papillary

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15
Q

Why does type 1 endometrial adenocarcinoma happen?

A

Continued exposure to oestrogen

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16
Q

Give five main people who develop type 1 endometrial adenocarcinoma?

A 
Obesity !! (responsible for recent increase, due to increasingly unhealthy lifestyle factors)
Nulliparous
Early menarche
Late menopause
HRT
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17
Q

Why do obese ladies

A

Androgens produced in adrenal cortex

Aromatised in fat to oestrogen

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18
Q

What happens in type 2 endometrial adenocarcinoma?

A

Arises spontaneously in post-menopausal wp,em

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19
Q

What is the danger of type 2 endometrial carcinoma?

A

Occurs in women with shruncken uteri, easily becomes malignant

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20
Q

Give some of the macroscopic features of endometrial adenocarcinoma

A

Glands present
Malignant epithelium
Invades adnexa (structures closely related to uterus)

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21
Q

What is the precursor for endometrial cancer?

A 
• simple 
   o cystic glands, abundant     stroma 
• complex 
    o crowded, branched or budded glands 
• complex with atypia 
o cytological features of malignancy of 
varying degrees (EIN)
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22
Q

Name two different types of endometrial carcinoma, other than 1 and 2

A

Carcinosarcoma

Endometrial stromal sarcoma

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23
Q

What is a leiyomyoma?

A

Smooth muscle cancer (fibroids!)

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24
Q

What are the sy,ptoms of smooth muscle leiomyoma (fibroids)

A

Heavy/painful periods
Infertility
Benign

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25
Q

Give histological features of leiomyoma (3)

A 
Interlacing 
bundles of smooth 
muscle 
• rounded ends to 
nuclei 
• fibrotic or myxoid 
stroma
26
Q

Is leiomyoma benign or malignant?

A

Benign

27
Q

Is leiomyosarcoma benign or malignant?

A

Malignant

28
Q

Where does leiomyosarcoma metastasise?

A

Lungs

29
Q

Give four cells from which ovarian neoplasms can arise?

A 
o surface epithelium 
o stroma 
o sex cord components 
o germ cells 
o metastases
30
Q

What is confusing about ovarian neoplasm?

A

Everything

But symptoms are common with IBS, a common bowel condition

31
Q

What are the most common ovarian cancers?

A

Serous
Mucinous
Endometrioid
Brenner (transitional cell)

32
Q

Is ovarian carcinoma benign or malignant?

A

Can be both

33
Q

What do mucinous ovarian tumours look like?

A
  • intestinal or
    (rarely)
    endocervical
    mucin secreting
    epithelium
    Is often caused by spread from intestines/pancreas
34
Q

What is endometrioid carcinoma related to?

A

Endometriosois, often develops secondary in those with past endometriosis who go on HRT

35
Q

What do ovarian epithelial neoplasms develop as a result of? (talking ‘bout secretion from somewhere)

A

1) Fallopian tube secretions from STIC (serous tubal intraepithelial carcinoma)

36
Q

Give four causes of ovarian epithelial neoplasms

A

Smoking
HRT
Obesity
TAYLCUM POWDEER

37
Q

Give three kinds of sex cord stromal tumours

A

Granulosa cell tumour
• Fibroma/thecoma
• Sertoli Leydig cell tumour

38
Q

What can a granulosa cell tumour cause in young people?

A

Iso-sexual precocious puberty as a result of oestrogen secretion

39
Q

What is a key feature of granulosa cell tumour histologically?

A

Call-Exner Bodies (little white balls in the blue)

40
Q

What do leydig cell tumours cause in mails?

A

Androgen production and virilisation

41
Q

What do you see histologically in leydig cell tumours?

A

Crystals of Reinke (

42
Q

What is a mature cystic teratoma?

A

An ovarian germ cell tumour

43
Q

What is odd and disgusting about mature cystic teratoma

A 
Skin
Hair 
Teeth
Bone 
ALL INSIDE THE OVARY
44
Q

What is a good marker for an endodermal sinus tumour?

A

AFP BHCG

45
Q

Give three types of vulval tumour (IMPORTANT(

A

Squamous carcinoma
Adenocarcinoma
Basal cell carcinoma

46
Q

Where is vulval carcinoma found?

A

Mainly labia

47
Q

Give three macroscopic features of vulval carcinoma

A

Keratotic, watey or ulcerated

48
Q

How is vulval carcinoma caused?

A

HPV

49
Q

Give four features of a vulval rash which is indicatve of vulvular carcinoma

A

Scaly red patch
• sore
• itchy
• white

50
Q

What is the histology of a vulval carcinoma?

A

Abnormal maturation
Mitotic activity above basal layer
Basloid cells above basal layer

51
Q

What is vuval basal cell carcinoma?

A

Pearly white or pigmented nodule
Ulcerated
Labium majora effected

52
Q

Describe key features of gestational tumours

A

a

53
Q

What is a hydatiform mole? (IMPORTANT)

A

An abnormal form of pregancy in which a non-viable fertilised egg implants in uterus.

54
Q

When does hydatiform mole form?

A

Dispermic (complete 46 XX or 46 XY

One egg nuclei and two sperm (69 XXY)

55
Q

What is the danger of a hydatidiform mole?

A

10% risk of malignancy

56
Q

What occurs in a placental site trophoblastic tumour?

A

Intermediate trophoblastic cells colonis the blood vessels, widening them. If that does not happen eclampsia.

hese can cause tumooouuursss.

57
Q

What are the most common types of vulval carcinoma?

A

Squamous carcinoma

58
Q

What is the major causative factor of vulval cancer in pre-menopausal women?

A

HPV

59
Q

What is the focal point for the development of vulval cancer?

A

VIN (vulval intraepithelial neoplasia) from HPV invasion into intraepithelial cells

60
Q

What is an early cure for precursor to vulval cancer?

A

VIN excision

61
Q

What are the causative agents of vulval carcinoma in older women?

A

Chronic irritation and longstanding dermatoses such as lichen sclerosus and squamous hyperplasia

Semester 4 - Reproductive System (30 decks)

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