Uterine cancer Flashcards
Carcinoma of uterus subtypes
endometriod
papillary serous carcinomas
clear cell
adenosquamous
mucinous
undifferentiated
Difference between uterine carcinoma and sarcoma
carcinoma = arise from epithelial cells
- endometrial cells
sarcoma = arise from connective tissue
- myometrial and stromal cells
Endometrial cancer risk factors
excess oestrogen
nulliparity
early menarche
late menopause
unopposed oestrogen. The addition of a progestogen to oestrogen reduces this risk (e.g. In HRT)
metabolic syndrome
obesity
diabetes mellitus
polycystic ovarian syndrome
tamoxifen
hereditary non-polyposis colorectal carcinoma
Endometrial cancer presentation
post-menopausal bleeding
perimenopausal bleeding
vaginal discharge
bulky uterus on examination
What endometrial thickness has a significant risk of endometrial malignancy?
> 10mm
Hysteroscopy risks
bleeding
infection
uterine perforation
When to remove endometrial polyps?
symptomatic women
women with risk factors for endometrial cancer/hyperplasia (post-menopausal, obese, PCOS, DM, tamoxifen)
polyp >2cm (pre-menopausal)
polyp >1cm (post-menopausal)
Define endometrial hyperplasia
proliferation of endometrial glands leading to a greater gland to stroma ratio than in normal endometrium
What is simple endometrial hyperplasia?
increase in number of glands but appear architecturally and cytologically normal
What is complex endometrial hyperplasia?
increase in number of glands which appear architecturally abnormal but cytologically normal
What is atypical endometrial hyperplasia?
increase in number of glands which appear both architecturally and cytologically abnormal, but no stromal invasion
Investigations for suspected endometrial cancer
pelvic USS
endometrial biopsy
hysteroscopy
FIGO staging of endometrial cancer
stage 1 = confined to uterus
stage 2 = involves cervix
stage 3 = vagina, lymph node and pelvic extension
stage 4 = distant metastases
