Uterine Cancer Flashcards

1
Q

When is it most common to develop endometrial polyps?

A

Around or after the menopause

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2
Q

What are the 3 subgroups of endometrial hyperplasia?

A

Simple
Complex
Atypical

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3
Q

What causes endometrial hyperplasia?

A

Unknown but may be persistent oestrogen stimulation

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4
Q

Describe the pathology of simple endometrial hyperplasia, discussing distribution, components, gland appearance and cytology

A

Generalised distribution
Glands and stroma involved
Dilated glands
Normal cytology

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5
Q

Describe the pathology of complex endometrial hyperplasia, discussing distribution, components, gland appearance and cytology

A

Focal distribution
Glands involved
Crowded glands
Normal cytology

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6
Q

Describe the pathology of atypical endometrial hyperplasia, discussing distribution, components, gland appearance and cytology

A

Focal distribution
Glands involved
Crowded glands
Atypical cytology

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7
Q

How does endometrial hyperplasia typically present?

A

Bleeding - dysfunctional uterine bleeding or post-menopausal bleeding

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8
Q

Endometrial carcinoma is uncommon under the age of 40. True/False?

A

True

Mainly 50-60 yr olds

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9
Q

What are the 2 main groups of endometrial carcinoma and their precursor lesions?

A

Type 1: endometrioid, derived from atypical hyperplasia

Type 2: serous carcinoma, derived from serous intraepithelial carcinoma

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10
Q

Most endometrial carcinoma is what - adenocarcinoma or squamous cell carcinoma?

A

Adenocarcinoma

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11
Q

What causes endometrioid endometrial carcinoma?

A

Unopposed oestrogen stimulation

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12
Q

Which is more common - endometrioid or serous endometrial carcinoma?

A

Endometrioid

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13
Q

What is the biggest risk factor for endometrial cancer?

A

Obesity

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14
Q

Why is obesity associated with endometrial cancer?

A

Adipocytes express aromatase which converts androgens to oestrogens, inducing endometrial proliferation

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15
Q

What is the effect of insulin upon the endometrium?

A

Exerts proliferative effect on endometrium

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16
Q

Which syndrome is related to endometrioid endometrial carcinoma and increases the risk of colorectal cancer?

A

Lynch syndrome

AKA hereditary non-polyposis colorectal cancer

17
Q

What is the genetic abnormality in lynch syndrome?

A

Autosomal dominant mutation in DNA mismatch repair gene

18
Q

What should be tested for in cancer tissue in someone with lynch syndrome?

A

Microsatellite instability (MSI)

19
Q

Serous endometrial carcinoma is more aggressive/invasive than endometrioid endometrial carcinoma. True/False?

A

True

20
Q

What does the prognosis of endometrial cancer depend on?

A

Staging
Histological grading
Depth of myometrial invasion

21
Q

How is endometrioid endometrial carcinoma graded?

A

By architecture
Grade 1: 5% or less solid growth
Grade 2: 6-50% solid growth
Grade 3: above 50% solid growth

22
Q

How is serous endometrial carcinoma graded?

A

It’s not!

It’s high-grade by nature

23
Q

Describe a stage 1 endometrial cancer

A

Confined to uterus
IA: no or less than 50% invasion
IB: invasion more than or equal to 50%

24
Q

Describe a stage 2 endometrial cancer

A

Invasion of cervical stroma

25
Q

Describe a stage 3 endometrial cancer

A

Local or regional spread
IIIA: serosa of uterus and/or adnexae
IIIB: vaginal involvement
IIIC: pelvic/para-aortic lymoh node spread

26
Q

Describe a stage 4 endometrial cancer

A

Invasion of bladder or bowel mucosa and/or distant metastases

27
Q

What are the 2 main myometrial tumours that can occur?

A

Leiomyoma (benign, common)

Leiomyosarcoma (malignant, rare)

28
Q

What is another name for a leiomyoma?

A

Uterine fibroid

29
Q

What is the most common uterine sarcoma?

A

Leiomyosarcoma