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1. Reproduction > Uterine Cancer > Flashcards

Uterine Cancer Flashcards

1
Q

When do endometrial polyps occur?

A

around or after menopause

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2
Q

What are the 3 types of endometrial hyperplasia?

A

simple
complex
atypical

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3
Q

What defines simple endometrial hyperplasia?

A

glands + stroma
glands are dilated
normal cytology

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4
Q

What defines complex endometrial hyperplasia?

A

focal distribution
glands are crowded
no stroma
normal cytology

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5
Q

What defines atypical endometrial hyperplasia?

A

focal distribution
glands are crowded
no stroma
abnormal cytology

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6
Q

What is the peak age incidence of endometrial carcinoma?

A

50-60years

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7
Q

What predisposes you do endometrial carcinoma?

A

Lynch syndrome

PCOS

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8
Q

How does endometrial carcinoma present?

A

abnormal bleeding

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9
Q

What are the different types of endometrial carcinoma?

A

both adenocarcinomas:
Endometrioid carcinoma - type 1
Serous and Clear cell - type 2

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10
Q

Describe Endometrioid carcinoma - type 1?

A

related to unopposed oestrogen

associated with atypical hyperplasia

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11
Q

What is more common Endometrioid carcinoma - type 1 or Serous and Clear cell - type 2?

A

Endometrioid carcinoma - type 1 - 80%

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12
Q

What are risk factors for Endometrioid carcinoma - type 1?

A

obesity - adipocytes expresss aromatase that converts androgens -> oestrogen
increase in free insulin levels leads to endometrial proliferation

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13
Q

What causes Serous and Clear cell - type 2?

A

TP53 mutation and over expression

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14
Q

What is the precursor lesion for Serous and Clear cell - type 2?

A

serous endometrial intraepithelial carcinoma

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15
Q

How does Serous and Clear cell - type 2 spread?

A

along the Fallopian tubes mucosa and peritoneal surfaces (so can persent with extra uterine disease)

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16
Q

What is more aggressive Endometrioid carcinoma - type 1 or Serous and Clear cell - type 2?

A

Serous and Clear cell - type 2

17
Q

What is the treatment for endometrial carcinoma?

A

surgery - total abdominal hysterectomy with bilateral salpingoophrectomy and peritoneal washings (TAH-BSO)
radiotherapy as adjuvant
chemo if high grade

18
Q

How is endometroid carcinoma graded?

A

grade 1 - 5% or less solid growth
grade 2 - 6-50% solid growth
grade 3 - >50% solid growth (can no longer form glands)

19
Q

What is an endometrial stromal carcinoma?

A

can be low grade or high grade and resemble endometrial stroma
it can infiltrate the myometrium and lymphovascular system

20
Q

How does endometrial stromal carcinoma present?

A

abnormal bleeding or metastasis - ovary or lung

21
Q

How do leiomyosarcomas present?

A

women >50
abnormal vaginal bleeding
palpable pelvic mass
pelvic pain

22
Q

What is the prognosis of leiomyosarcomas?

A

poor - even if confined

5yr survival 15-25%

23
Q

How do leiomyomas present?

A

pelvic mass and abnormal uterine bleeding

women >40s

24
Q

What different places can leiomyomas/fibroids present?

A 
submucous
subserous
intracavitary
pedunculated
intramural
25
Q

What medical treatment can be given for fibroids?

A

mirena
GnRH analogues
progestins - OCP

26
Q

What surgical treatment can be given for fibroids?

A

laparotomy/laproscopic

27
Q

What must be done in an acute presentation of a fibroid degeneration?

A

myomectomy

subtotal or total hysterectomy

28
Q

How does endometriosis present?

A

severe dysmennorhoea
pre menstrual pain
dysparenuia

29
Q

What are the consequences of endometriosis?

A

subfertility
ectopic pregnancy
cyst formation pain
malignancy

30
Q

What is the first line investigation for endometrial cancer?

A

pipelle biopsy - can do in a GP

31
Q

What is an endometrioma?

A

endometriosis in the ovary

32
Q

What are endometriotic cysts?

A

endometrium in the wrong place eg ovary

blood filled cysts

33
Q

What is an adenomyosis?

A

endometriosis in the myometrium

34
Q

What are the two types of functional cysts?

A

follicular or luteal - form when ovulation doesnt occur

35
Q

Describe functional cysts?

A

usually <5cm in diameter
asymtomatic and resolve spontaneously
may bleed/rupture and cause pain
lined by grnaulosa cells

1. Reproduction (50 decks)

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