Tumours Of The Reproductive Tract Flashcards
What type of cancers may appear on the vulva?
Squamous cell carcinoma,
Basal cell carcinoma,
Melanoma,
Soft tissue tumours.
What does in situ mean?
Tumour has not yet breached the basement membrane. No invasion.
What percentage of vulval SS carcinomas are related to HPV?
What are others associated with?
30%.
70% associated with longstanding inflammatory conditions.
Where does vulval cancer often spread to?
Anus vagina and bladder directly.
Inguinal, iliac and paraaortic lymph nodes.
Lung and liver.
How do cervical cancers commonly develop?
Oestrogen causes the cervical columnar epithelium to evert into the vagina, exposing it to acidic conditions and inducing metaplasia. This predisposes to dysplasia, formation of cervical intraepithelial neoplasia and squamous cell carcinomas.
Which strains of HPV are linked with oral, anal, cervical and vulval cancers?
How so?
HPV 16 and 18.
Produce viral proteins E6 and E7 that inactivate p53 and Rb.
What are CIN stages 1-3?
Dysplasia beginning from the basement membrane and progressively rising to the surface layer. Will likely eventually breach the basement membrane and become squamous cell carcinoma.
What risk factors are there for CIN?
HPV exposure, Early first pregnancy, Multiple births, Smoking, Immunosuppression.
What treatment is done for CIN1, 2 and 3?
1 - regresses spontaneously
2 and 3 - colposcopy alongside large loop excision of transformation zone.
When is cervical cancer screened for?
How is it done?
In 25-49 yo - every 3 years.
In 50-64 yo - every 5 years.
A brush is used to scrape cells and these are tested for HPV. If affected, they are looked at under a microscope.
What vaccination is there for HPV?
Gardasil against HPV 6,11,16,18
What cancers may arise in the cervix?
Squamous cell carcinoma,
Adenocarcinoma.
How might invasive cervical cancer present?
Bleeding - postcoital, intermenstrual or post menopausal.
Often picked up after screening.
How is invasive cervical cancer managed?
Hysterectomy and lymph node dissection +- chemoradiotherapy.
What is endometrial hyperplasia?
Increased gland:stromatolites ratio with endometrium thickened to >7mm. Can precede endometrial cancer.