Uterine Cancer Flashcards
what is hyperplasia?
an increase in the number of cells
what are the three types of endometrial hyperplasia?
simple
complex
atypical
which type of endometrial hyperplasia is a precursor of carcinoma?
atypical
what is one possible cause of endometrial hyperplasia?
persistent oestrogen stimulation
how does endometrial hyperplasia present?
abnormal bleeding
when is the peak incidence of endometrial carcinoma?
50-60 years old
uncommon under 40
what should be considered in young women with endometrial carcinoma?
underlying conditions
i.e. PCOS, Lynch syndrome
what are the two main groups of endometrial carcinoma?
endometrioid carcinoma
serous carcinoma
what is the precursor of an endometrioid endometrial carcinoma?
atypical hyperplasia
what is a type one endometrial carcinoma?
endometrioid endometrial carcinoma
which type of endometrial carcinoma is most common?
endometrioid
what is endometrioid endometrial carcinoma related to?
unopposed oestrogen
what are the two types of endometrioid endometrial carcinoma?
endometrioid
mucinous
what mutations are associated with endometrioid endometrial carcinoma?
PTEN
KRAS
PIK3CA
what is the precursor for serous endometrial carcinoma?
serous intraepithelial carcinoma
what is a type two endometrial carcinoma?
serous endometrial carcinoma
who gets serous endometrial carcinomas?
elderly, postmenopausal
what mutation is often associated with serous endometrial carcinoma?
TP35
what are the two phenotypes of serous endometrial carcinoma?
serous
clear cell
how can serous endometrial carcinoma spread?
along Fallopian tube mucosa and onto peritoneal surfaces
what is the more aggressive type of endometrial carcinoma?
serous endometrial carcinoma
how does endometrial carcinoma usually present?
abnormal bleeding
how can endometrial carcinoma spread?
directly
lymphatic
haematogenous
where can endometrial carcinoma spread directly?
myometrium
cervix
what are the stages for endometrial carcinoma?
I-IV
what does prognosis of endometrial carcinoma depend on?
stage
histological grade
depth of myometrial invasion
what are the treatment options for endometrial carcinoma?
hysterectomy
chemotherapy
radiotherapy
define a grade 1 endometrioid endometrial carcinoma
5% or less solid growth
define a grade 2 endometrioid endometrial carcinoma
6-50% solid growth
define a grade 3 endometrioid endometrial carcinoma
> 50% solid growth
what is a stage I endometrial carcinoma?
confined to the uterus
what is a stage IA endometrial carcinoma?
no/<50% myometrial invasion
what is a stage IB endometrial carcinoma?
invasion equal to or >50% of myometrium
what is a stage II endometrial carcinoma?
tumour invades cervical stroma
what is a stage III endometrial carcinoma?
local and/or regional tumour spread
what is a stage IIIA endometrial carcinoma?
tumour invades serosa of uterus and/or adnexae
what is a stage IIIB endometrial carcinoma?
vaginal and/or parametrical involvement
what is a stage IIIC endometrial carcinoma?
metastases to pelvic and/or para-aortic lymph nodes
what is a stage IV endometrial carcinoma?
tumour invades bladder and/or bowel mucosa (IVA)
and/or distant metastases (IVB)
what is endometrial stromal sarcoma?
tumour arising from the endometrial stroma
where can endometrial stromal sarcoma invade?
myometrium
lymph-vascular spaces
where can endometrial stromal sarcoma invade?
myometrium
lymph-vascular spaces
how do endometrial stromal sarcoma usually present?
AUB
metastasis
where do endometrial stromal sarcoma commonly metastasise to?
ovary
lung
what is the most important prognostic factor for endometrial stromal sarcoma?
stage
what is endometrial carcinosarcoma?
a mixed tumour with malignant, epithelial and stromal elements
who tends to get endometrial carcinosarcoma?
elderly women
what is the prognosis like for endometrial carcinosarcoma?
poor
very aggressive
what is an older name used for endometrial carcinosarcoma?
mixed Mullerian tumour
what are two possible smooth muscle tumours of the myometrium?
leiomyoma (benign)
leiomyosarcoma (malignant)
what is another name for uterine leiomyoma?
uterine fibroids
what is uterine leiomyoma associated with?
menorrhagia
infertility
what is seen in morphology of leiomyosarcoma?
spindle cells
what is the most common uterine sarcoma
leiomyosarcoma
who is most commonly affected by leiomyosarcoma?
women over 50
what are the most common symptoms of leiomyosarcoma?
abnormal vaginal bleeding
palpable pelvic mass
pelvic pain