Tumours of the reproductive tract Flashcards
What type of tumours are vulval tumours?
squamous cell carcinomas
Can also get BCC and melanoma (rare)
Who do vulval tumours normally affect?
Older women
What are the causes for vulval carcinoma in elderly women?
Long-standing dermatoses e.g. lichen sclerosis and squamous hyperplasia
(White lesions on the skin that are not caused by irritation)
What is the main cause of vulval carcinoma in pre-menopausal women?
HPV with invasion developing from the precursor ; VIN
What is VIN?
Vulval intraepithelial neoplasia
Where does vulval tumours spread to?
Inguinal lymph nodes (easiest)
Where does vulval cancer spread to by direct extension?
Anus, Vagina, bladder
What other lymph nodes do vulval cancers spread to?
Iliac and para-aortic as well as inguinal
Where does vulval cancer have distant metastasis?
Lungs and liver
What would definitive surgery include for vulval carcinomas?
Removing the primary tumour and nodes
What clinical features would you see on vulval cancers?
Lumps, ulceration and skin changes, pigmentation
What is the inner part of the cervix called and what is it made from?
Endocervix Glandular epithelium (columnar)
What is the outer part of the cervix called and what is it made of?
Ectocervix
Stratified squamous epithelium - best to deal with the harsh environment of the vagina
What is the transformation zone?
Where metaplasia occurs between the 2 epithelial types - important in cervical carcinoma
What are the majority of cervical cancers?
Squamous cell carcinomas (80%)
Adenocarcinomas (15%)
What is the difference between SCC and AC?
SCC - cancers of the squamous cells
AC - glandular cancer that starts in the glandular epithelium that lines an organ
What does SCC look like under a microscope?
No structural architecture
- atypical cells (big nuceli, mitoses (marker of proliferation)
- keratin production - forming whirls and swirls in middle of tumour
What is VIN?
In situ precursor of vulval squamous cell carcinoma
- not invaded through the basement membrane
- VIN may or may not develop into SCC
What happens when you oestrogen to the cervix
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