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Repro > Uterine Cancer > Flashcards

Uterine Cancer Flashcards

1
Q

When are endometrial polyps common?

A

Around/After menopause

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2
Q

What is atypical endometrial hyperplasia?

A

Precursor of carcinoma

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3
Q

In terms of Dilation, Component, Glands and Cytology, describe simple endometrial hyperplasia

A

General
Glands + Stroma
Dilated not crowded
Normal

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4
Q

In terms of Dilation, Component, Glands and Cytology, describe complex endometrial hyperplasia

A

Focal
Glands
Crowded
Normal

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5
Q

In terms of Dilation, Component, Glands and Cytology, describe atypical endometrial hyperplasia

A

Focal
Glands
Crowded
Atypical

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6
Q

When does endometrial carciinoma usually occur?

A

50-60 years

Uncommon under 40

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7
Q

What should be considered in younger women?

A

Underlying predisposition e.g. PCOS or Lynch syndrome

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8
Q

What is endometrioid carcinoma associated with?

A

Precursor atypical hyperplasia

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9
Q

What is serous carcinoma associated with?

A

Precursor serous intraepithelial carcinoma

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10
Q

What do carcinomas usually present with?

A

Abnormal bleeding

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11
Q

What is seen macroscopically in endometrial carcinoma?

A

Large uterus

Polypoid

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12
Q

What is seen microscopically in endometrial carcinomas?

A

Most are adenocarcinomas

Most are well differentiated

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13
Q

What spread is assoc. with endometrial carcinoma?

A

Directly into myometrium and cervix
Lymphatic
Haematogenous

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14
Q

What are type 1 endometrial carcinoma tumours?

A

Endometrioid (and mucinous)

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15
Q

What are type 1 tumours assoc. with?

A

Related to unopposed oestrogen

Atypical hyperplasia

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16
Q

What are type 2 endometrial carcinoma tumours?

A

Serous (and clear cell)

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17
Q

What are type 2 tumours assoc. with?

A

Elderly post-menopausal women
TP53 often mutated
Not with unopposed oestrogen

18
Q

What 3 mutations are often seen in type 1 tumours?

A

PTEN
KRAS
PIK3CA

19
Q

What is Lynch syndrome?

A

Germline mutation of mismatch repair genes
Hereditary non-polyposius colorectal cancer)
Auto dominance

20
Q

What is a major risk factor for endometrial cancer?

A

Obesity

21
Q

Why is obesity a risk factor for endometrial cancer?

A

Adipocytes express aromatase that converts ovarian adrogens into oestrogens which induce endometrial proliferation

22
Q

What is lower in obese women?

A

Sex hormone-binding globulin

23
Q

What other hormone exerts proliferative effects upon the endometrium?

A

Insulin

Insulin like growth factor (IGF)

24
Q

How do type 2 tumours spread?

A

Along fallopian tube mucosa and peritoneal surfaces so can present with extrauterine disease

25
Q

How is serous carcinoma characterised?

A

Complex papillary and/or glandular architecture with diffuse, marked nuclear polymorphism

26
Q

Where does endometrial carcinoma usually infiltrate?

A

Myomerium

27
Q

Where may endometrial carcinoma spread early to?

A

Peritoneal cavity

28
Q

What does the prognosis of endometrial cancer depend on?

A

Stage
Histological grade
Depth of myometrial invasion

29
Q

What is the treatment for endometrial carcinoma?

A

Hysterectomy

Chemo/radiotherapy

30
Q

What are stage 1, and stage 1Aand 1B endometrial carcinomas?

A

Stage 1 is confined to the uterus
1A = <50% myometrial invasion
1B = >50%

31
Q

What is stage 2 endometrial carcinoma?

A

Tumour invades cervical stoma

32
Q

What is stage 3, 3A, 3B and 3C endometrial carcinoma?

A

Local or regional tumour spread
3A = invades serosa of uterus and/or adnexae
3B = vaginal and/or parametrial involvement
3C = Mets to pelvic and/or para-aortic lymph nodes

33
Q

What is stage 4 endometrial cancer?

A

Invades bladder and/or bowel mucosa (IVA) and/or distant mets (IVB)

34
Q

Where does an endometrial stromal sarcoma arise from?

A

Endometrial stroma

35
Q

What is a carcinosarcoma?

A

Mixed tumour with malignant epithelial and stromal elements

36
Q

What means a carcinosarcoma has the worst possible prognosis?

A

Rhabdomyosarcomatous component

37
Q

Name a fibroid smooth muscle tumour of the myometrium and it’s associations?

A

Leiomyoma

Mennorhagia and infertility

38
Q

Name a rarer myometrial smooth muscle tumour?

A

Leiomyosarcoma

39
Q

What does a Leiomyosarcoma display?

A

Spindle cell morphology

40
Q

When does a leiomyosarcoma occur?

A

Women >50 years

41
Q

What are common symptoms for leiomyosarcoma?

A

Abnormal vaginal bleeding
Palpable pelvic mass
Pelvic pain

42
Q

What is the 5 year survival rate for leiomyosarcoma?

A

15-25%

Repro (46 decks)

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