Uterine Cancer Flashcards
when are endometrial polyps common
around/after menopause
how does endometrial hyperplasia present
with abnormal bleeding (DUB or postmenopausal bleeding)
what are the three types of endometrial hyperplasia
simple, complex and atypical
what is the peak incidence of endometrial carcinoma
in 50-60 years, uncommon in under 40
if endometrial carcinoma presents in younger women consider
PCOS or Lynch syndrome
what is Lynch syndrome
HNPCC
how does endometrial carcinoma tend to present
with abnormal bleeding
what are the 2 main groups of endometrial carcinoma
endometriod and serous
what is the precursor lesion of endometriod carcinoma
atypical hyperplasia
what is the precursor of serous ccarcinoma
precursor serous intraepithelial carcinoma
what are endometriod cancers related to
unopposed oestrogen
endometriod are also called what tumours
type 1 tumours
serous (and clear cell) are called what tumours
type 2 tumours
are serous endometrial cancers associated with unopposed oestrogen
no
what is often mutated in endometrial carcinoma
TP53
describe features of type 1 tumours
endometriod and mucinous
PTEN, KRAS, PIK3CA mutations
associated with atypical hyperplasia as a precursor lesion
microsatellite instability
-germline mutation of mismatch repair genes (Lynch syndrome)
what is a risk factor for endometrial cancer and why
obesity
adipocytes express aromatase that convert ovarian androgens into oestrogen which induce endometrial proliferation
insulin action is reduced IGF exert a proliferative effect on endometrium
Lynch syndrome can increase which type of cancers
colorectal cancer
endometrial cancer
ovarian cancer
what causes Lynch syndrome
defective DNA mismatch repair gene
how can this type of tumour be identified
IHC of the tumour for mismatch repair proteins
MSI-microsatellite instability
features of type II tumours
serous and clear cell
TP53 mutation and overexpression
spreads along fallopian tube mucosa and peritoneal surface so can present with extrauterine disease
more aggressive
serous carcinoma pathology
complex papillary and/or glandular architecture with diffuse, marked nuclear pleomorphism
where does endmetriod carcinoma tend to spread
inifiltrates the myometrium
how are serous carcinoma graded
not formally graded
