Uterine Cancer Flashcards
When is it most common to develop endometrial polyps?
Around or after the menopause
What are the 3 subgroups of endometrial hyperplasia?
Simple
Complex
Atypical
What causes endometrial hyperplasia?
Unknown but may be persistent oestrogen stimulation
How does endometrial hyperplasia typically present?
Bleeding - dysfunctional uterine bleeding or post-menopausal bleeding
Endometrial carcinoma is uncommon under the age of 40. True/False?
True
Mainly 50-60 yr olds
What are the 2 main groups of endometrial carcinoma and their precursor lesions?
Type 1: endometrioid, derived from atypical hyperplasia
Type 2: serous carcinoma, derived from serous intraepithelial carcinoma
Most endometrial carcinoma is what - adenocarcinoma or squamous cell carcinoma?
Adenocarcinoma
What causes endometrioid endometrial carcinoma?
Unopposed oestrogen stimulation
Which is more common - endometrioid or serous endometrial carcinoma?
Endometrioid
What is the biggest risk factor for endometrial cancer?
Obesity
Why is obesity associated with endometrial cancer?
Adipocytes express aromatase which converts androgens to oestrogens, inducing endometrial proliferation
What is the effect of insulin upon the endometrium?
Exerts proliferative effect on endometrium
Which syndrome is related to endometrioid endometrial carcinoma and increases the risk of colorectal cancer?
Lynch syndrome
AKA hereditary non-polyposis colorectal cancer
What is the genetic abnormality in lynch syndrome?
Autosomal dominant mutation in DNA mismatch repair gene
What should be tested for in cancer tissue in someone with lynch syndrome?
Microsatellite instability (MSI)
Serous endometrial carcinoma is more aggressive/invasive than endometrioid endometrial carcinoma. True/False?
True
What does the prognosis of endometrial cancer depend on?
Staging
Histological grading
Depth of myometrial invasion
How is endometrioid endometrial carcinoma graded?
By architecture
Grade 1: 5% or less solid growth
Grade 2: 6-50% solid growth
Grade 3: above 50% solid growth
How is serous endometrial carcinoma graded?
It’s not!
It’s high-grade by nature
Describe a stage 1 endometrial cancer
Confined to uterus
IA: no or less than 50% invasion
IB: invasion more than or equal to 50%
Describe a stage 2 endometrial cancer
Invasion of cervical stroma
Describe a stage 3 endometrial cancer
Local or regional spread
IIIA: serosa of uterus and/or adnexae
IIIB: vaginal involvement
IIIC: pelvic/para-aortic lymoh node spread
Describe a stage 4 endometrial cancer
Invasion of bladder or bowel mucosa and/or distant metastases
What are the 2 main myometrial tumours that can occur?
Leiomyoma (benign, common)
Leiomyosarcoma (malignant, rare)
