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4th Year Oncology > Uterine and Cervical Tumours > Flashcards

Uterine and Cervical Tumours Flashcards

1
Q

What virus is one of the main causes of cervical cancer?

A

HPV – mainly 16 & 18

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2
Q

Is the OCP protective against or a risk factor for cervical cancer

A

A risk factor

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3
Q

What is the most common type of cervical cancer?

A

Squamous carcinoma

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4
Q

Where in the cervix does cervical cancer most commonly occur?

A

The transformation zone

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5
Q

How long does it take for a high grade CIN to become an invasive cancer?

A

5-20 years

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6
Q

Who is currently offered the HPV vaccine in Scotland

A

Girls S1-3 and MSM <45

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7
Q

What is the precursor to squamous carcinoma of the cervix?

A

Cervical intraepithelial neoplasia (CIN)

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8
Q

What is the difference between CIN I, CIN II & CIN III

A
  • CIN I = Basal 1/3 of epithelium occupied by abnormal cells – unlikely to progress to cancer
  • CIN II = Abnormal cells extend to middle 1/3 – may progress to cancer
  • CIN III – Abnormal cells occupy full thickness of epithelium – likely to progress to cancer
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9
Q

What is the precursor to adenocarcinoma of the cervix?

A

Cervical glandular intraepithelial neoplasia (CGIN)

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10
Q

Who is most at risk of vulvar carcinoma?

A

Elderly women

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11
Q

What cancer classically presents with a crusting rash on the vulva?

A

Vulvar paget’s disease (cancer arising from the sweat glands)

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12
Q

What age range is most at risk for endometrial cancer?

A

50-60

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13
Q

What is the most common type of uterine cancer?

A

Adenocarcinoma

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14
Q

Which is the more common uterine cancer, endometrial carcinoma or serous carcinoma?

A

Endometrial carcinoma

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15
Q

What is the difference between a stage IA and IB uterine tumour?

A

IA = no or <50% myometrial invasion

IB = ≥50% myometrial invasion

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16
Q

What is a stage II uterine tumour?

A

Tumour invades cervical stroma

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17
Q

What is a stage III uterine tumour?

A

Local and/or regional tumour spread:

  • IIIA = invading ovary
  • IIIB = Invades vagina
  • IIIC = pelvic mets and/or para-aortic lymph nodes
18
Q

What is a stage IV uterine tumour?

A

Tumour invades bladder and/or bowel (IVA) and/or distant mets (IVB)

19
Q

What is the most common reason a uterine cancer patient is unfit for surgery?

A

High BMI

20
Q

What treatment should you offer in the case of uterine cancer to young women who still desire fertility?

A

Mirena coil for a year, then remove and they have a year to get pregnant

21
Q

What is lynch syndrome?

A

A cancer predisposition syndrome that give high risk of colorectal and uterine cancers and an increased risk of ovarian

22
Q

Who is most at risk for leiomyomas/fibroids?

A

Women >40 and afro-caribbean women

23
Q

What hormone does the growth of leiomyomas/fibroids depend on?

A

Oestrogen

24
Q

What is the most common diagnostic test for leiomyomas/fibroids?

A

Ultrasound

25
Q

How is a fibroid seen on USS?

A

A smooth echogenic mass

26
Q

What is the gold standard treatment for leiomyomas/fibroids?

A

Hysterectomy - only if family is complete

27
Q

What is the name of the rare malignant tumour of smooth muscle that can occur in the uterus?

A

Leiomyosarcoma

28
Q

Name some causes of unopposed oestrogen that increases the risk of uterine cancer

A

HRT, Tamoxifen,

PCOS, nulliparity, infertility

29
Q

What thickness of endometrium in post-menopausal women is suspicious of endometrial cancer

A

> 3mm

30
Q

What is the best treatment for a stage I uterine cancer?

A

Total abdominal hysterectomy + bilateral salpingo-oophorectomy
OR
Progesterone for fertility sparing treatment

31
Q

What is the best treatment for a stage II uterine cancer?

A

Radical hysterectomy + adjuvant

radiotherapy

32
Q

What is the best treatment for a stage III or IVA (nodes) uterine cancer?

A 
Radical radiotherapy (external
beam and brachytherapy)
33
Q

What is the best treatment for a stage IVB (mets) uterine cancer?

A

Palliative – chemotherapy/

radiotherapy

34
Q

What is the peak age for cervical cancer?

A

40-45

35
Q

List some risk factors other than HPV for cervical cancer

A

 Early age at first pregnancy

 Multiparity

 Multiple sexual partners

 OCP

 Smoking

 DES exposure

 HIV (AIDS defining condition)

36
Q

Apart from EUA, what other technique can be used to obtain a biposy in suspected cervical cancer?

A

Colposcopy

37
Q

Between what ages is cervical screening done in Scotland?

A

Between 25 and 64 years

38
Q

What is the best treatment for early stage cervical cancer?

A

Surgery (radical hysterectomy/ trachelectomy)
+
Adjuvant radiotherapy if high risk features (+LN,
LVI, +ve margins)

39
Q

What is the best treatment for locally advanced cervical cancer?

A

Chemoradiotherapy

40
Q

What is the best treatment for metastatic cervical cancer?

A

Palliative chemoradiotherapy

4th Year Oncology (6 decks)

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