Uterine Cancer Flashcards
What are the three types of endometrial hyperplasia?
Simple
Complex
Atypical
What occurs in simple endometrial hyperplasia?
The glands and stroma of the entire endometrium begin to grow but not dilate
What occurs in complex endometrial hyperplasia?
Focal process where the glands become crowded
What occurs in atypical endometrial hyperplasia?
Focal process where the glands become crowded and premalignant
How is complex atypical hyperplasia treated?
Hysterectomy
What is the peak incidence for endometrial carcinoma?
50-60 years old
What are the two main groups of endometrial carcinoma?
Endometrioid
Serous
What are the precursor lesions for endometrioid and serous carcinomas?
Endometrioid - atypical hyperplasia
Serous - intraepithelial carcinoma
How do most endometrial cancers present?
Abnormal uterine bleeding
Endometrioid cancers are related to high levels of which hormone?
Oestrogen
Why does obesity increase risk of endometrial cancer?
As adipocytes express aromatase that converts ovarian androgens into oestrogens inducing endometrial proliferation
The level of sex hormone-binding globulin is higher/lower in obese woman?
Lower - means higher levels of biologically active hormone
What occurs in Lynch syndrome?
Defective DNA mismatch repair gene increases risk of colorectal/endometrial/ovarian cancer
Type I endometrial tumours involve which group of phenotypes?
Endometrioid and mucinous
Type II endometrial tumours involve which group of phenotypes?
Serous and clear cell
Type II tumours involve a mutation in which gene?
p53
Why may type II tumours present with extrauterine disease?
As they can spread along the uterine tube mucosa and peritoneal surfaces
Which are more aggressive - type I or II endometrial tumours?
Type II
How does serous carcinoma appear on histology?
Complex papillary architecture with diffuse nuclear pleomorphism
An endometrial carcinoma will typically infiltrate which structure?
Myometrium
How are endometrioid carcinomas graded?
By the amount of solid growth
What are the stages of endometrial cancer?
I - myometrium invasion
II - cervical stroma invasion
III - local/regional tumour spread
IV - bladder/bowel mucosa invasion or distant mets
What is a tumour arising from endometrial stroma called?
Endometrial stromal sarcoma
What tissue is found in carcinosarcomas?
Epithelial (carcinoma) Connective tissue (sarcoma)
What is a leiomyosarcoma?
A malignant smooth muscle tumour
What morphology does leiomyosarcoma commonly display?
Spindle cell morphology
