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Reproductive System > Tumours of Reproductive Tract > Flashcards

Tumours of Reproductive Tract Flashcards

1
Q

What is the most common type of vulval cancer?

A

Squamous cell carcinoma

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2
Q

What are the clinical features of vulval cancer?

A

Lumps
Skin changes
Ulvers

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3
Q

What is VIN?

A

Vulval intraepithelial neoplasia

In situ precursor to vulval SCC - atypical cells confined to epidermis

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4
Q

Where can vulval cancer spread?

A

Direct

  • anus
  • vagina
  • bladder

Lymph nodes

  • inguinal
  • iliac
  • para-aortic

Mets

  • lungs
  • liver
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5
Q

What is the cervical transformation zone?

A

During puberty - oestrogen increases
Cervix exerts - simple columnar epithelium is exposed to low vaginal pH
Metaplasia (stratified squamous) occurs = transformation zone

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6
Q

What HPV subtypes are a risk for cervical cancer?

A

HPV 16

HPV 18

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7
Q

How does HPV increase risk of cervical cancer?

A

Infects transformation zone
Produces viral proteins E6 + E7
E6/7 inactivate tumour suppressor genes
Results in uncontrolled cell growth

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8
Q

What is CIN?

A

Cervical intraepithelial neoplasia

Dysplasia caused by HPV confined to cervical epithelium

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9
Q

What are the stages of CIN?

A

CIN 1 - mild
CIN 2 - moderate
CIN 3 - severe

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10
Q

What are risk factors for CIN/cervical cancer?

A 
Increased risk of HPV 
Early pregnancy 
Multiple births
Smoking 
Immunosuppression
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11
Q

What is the management for CIN1?

A

Often regresses spontaneously

Follow up smear in 1 year

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12
Q

What is the management for CIN2/3?

A

Large loop excision of transformation zone

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13
Q

When should you receive a cervical smear?

A

25-49 = every 3 years
50-64 = every 5 years
65 + = only if recent abnormality

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14
Q

What are the common types of cervical cancer?

A

SCC

Adenocarcinoma

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15
Q

How does cervical cancer present?

A

Bleeding

  • post-coital
  • intermenstrual
  • post menopausal

Mass

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16
Q

How is cervical cancer staged?

A

Stage 1 = confined to cervix
Stage 2 = disease beyond cervix
Stage 3 = disease to pelvic wall or lower 1/3 of vagina
Stage 4 = invades bladder, rectum or metastases

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17
Q

How is cervical cancer managed?

A

Hysterectomy
Lymph node dissection
Chemoradiotherapy

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18
Q

What is endometrial hyperplasia?

A

Thickened endometrium >11mm

Precursor to endometrial cancer

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19
Q

What causes endometrial hyperplasia?

A

Excessive oestrogen

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20
Q

How does endometrial cancer present?

A

Intermenstrual bleeding
Postmenopausal bleeding
Mass

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21
Q

What are the types of endometrial cancer?

A

Endometrioid adenocarcinoma

Serous

22
Q

What is endometrioid adenocarcinoma?

A

Most common endometrial cancer

Resembles normal endometrial glands

23
Q

How is endometrioid adenocarcinoma staged?

A 
Stage 1 = in endometrium 
Stage 2 = cancer grown into cervix
Stage 3a = cancer spread into ovary 
Stage 3b = cancer spread into vagina 
Stage 3c = cancer spread into lymph nodes
Stage 4a = cancer in bladder/bowel 
Stage 4b = cancer in distant organ
24
Q

What is serous endometrial cancer?

A

More aggressive cancer with poorly differentiated cells

25
Q

How does serous carcinoma spread

A

Exfoliates
Travels through fallopian tubes
Deposits on peritoneal surface

Associated with psammoma bodies - calcium collections

26
Q

How is endometrial cancer managed?

A

Hysterectomy
Bilateral sapingo-oophrectomy

+/- lymph node dissection
+/- chemoradiotherapy

27
Q

What tumours can affect the myometrium?

A

Leiomyoma

Leiomyosarcoma

28
Q

What is leiomyoma?

A

Benign, well circumcised tumour in myometrium

29
Q

How does a leiomyoma present?

A

Asymptomatic

Pelvic pain
Heavy periods
Urinary frequency - bladder compression

30
Q

What is leiomyosarcoma?

A

Malignant tumour of smooth muscle

31
Q

How does ovarian cancer present?

A

Early symptoms = vague

Late symptoms

  • abdo pain
  • abdo distension
  • urinary symptoms
  • hormonal disturbances
32
Q

What is a serum marker for ovarian cancer?

A

Ca-125

33
Q

What are the subtypes of ovarian tumours?

A

Epithelial
Germ cell
Sex cord stromal

34
Q

What types of epithelial ovarian tumours are there?

A

Serous
Mucinous
Endometrioid

35
Q

What is the appearance of ovarian serous tumours?

A

Highly atypical pleomorphic cells

Often show psammoma bodies

36
Q

Where can ovarian serous tumours spread?

A

Peritoneal surface

37
Q

What is the appearance of ovarian mucinous tumours?

A

Atypical epithelial cells

Secrete mucin

38
Q

What is the appearance of ovarian endometrioid tumours?

A

Glands resembling endometrium

39
Q

What types of germ cell ovarian tumours are there?

A 
Teratoma 
Dysgerminoma 
Choriocarcinoma 
Embryonal carcinoma 
Yolk sac tumour
40
Q

What are the types of teratoma?

A

Mature - benign
Immature - malignant
Monodermal

41
Q

What is a mature teratoma?

A

Also known as a dermoid cyst

Contains fully mature differentiated tissue

42
Q

What is an immature teratoma?

A

Contains immature embryonal tissue

43
Q

What is a monodermal teratoma?

A

Teratoma comprised almost entirely of one cell type

Benign

44
Q

What is the most common tissue in a monodermal teratoma?

A

Thyroid tissue

45
Q

What are the sex cord stromal ovarian tumours?

A

Tumours resembling

  • Sertoli-Leydig cells
  • granulosa-theca cells
46
Q

What is the effect of granulosa/theca cell ovarian tumours?

A

Produce oestrogen

Precocious puberty
Endometrial hyperplasia

47
Q

What is the effect of Sertoli/Leydig cell ovarian tumours?

A

Produce testosterone

Sterility
Amenorrhea
Hirsuitism

48
Q

What cancers commonly metastasise to the ovary?

A

Breast
GI
Other gynae tumours

49
Q

What is a risk factor for testicular cancer?

A

Cryptorchidism

50
Q

What is the presentation of testicular cancer?

A

Mass /- pain

51
Q

What are the subtypes of testicular cancer?

A

Germ cell

  • seminomatous - seminoma
  • non-seminomatous - teratoma

Non-germ cell
- sex cord stromal - Leydig/Sertoli

52
Q

What are testicular cancer markers?

A

B hCG - choriocarcinoma

Alpha fetoprotein - yolk sac tumours

Reproductive System (22 decks)

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