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Repodction > Uterine Malignancy > Flashcards

Uterine Malignancy Flashcards

1
Q

When do endometrial polyps often occur?

A

Around/after the menopause

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2
Q

If a young woman gets endometrial cancer, what conditions should you bear in mind?

A
  • PCOS

- Lynch syndrome

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3
Q

Atypical hyperplasia is the precursor for which type of endometrial cancer?

A

Endometriod carcinoma

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4
Q

Serous intraepithelial carcinoma is the precursor for which type of cancer?

A

Serous carcinoma

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5
Q

Are endometrial carcinomas more likely to be adenocarcinomas or squamous?

A

ADENOCARCINOMA

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6
Q

What is the myometrium?

A

Middle layer of the uterus wall

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7
Q

How does an endometrial carcinoma spread?

A
  • HAEMATOGENOUS

- directly into myometrium and cervix

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8
Q

TP53 is often mutated in which type of endometrial cancer?

A

Serous (and clear cell)

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9
Q

What does aromatase do?

adipocytes express aromatase

A

It converts ovarian androgens into OESTROGENS (this induces endometrial proliferation)

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10
Q

Effect of insulin on the endometrium?

A

Insulin/insulin-like growth factors (IGF) exert a proliferative effect on the endometrium

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11
Q

Insulin action in obese people and its role in endometrial cancer

A

Insulin action is often altered in obese women: The level of insulin-binding globulins is reduced and free insulin levels are elevated. Insulin/insulin-like growth factors (IGF) exert proliferative effect on endometrium.

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12
Q

SHBG levels in obese people and its role in endometrial cancer?

A

Sex hormone-binding globulin levels are lower in obese women, and therefore the level of unbound, biologically active hormone is higher.

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13
Q

Lynch syndrome inheritance

A

Autosomal Dominant

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14
Q

How could you identify a tumour in Lynch syndrome

A

Immunohistochemistry staining (for mismatch repair proteins)

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15
Q

Name a characteristic of defective mismatch repair

A

Microsatellite instability

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16
Q

Characterised by a complex papillary and/or glandular architecture with diffuse, marked pleomorphism

A

Serous carcinoma

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17
Q

How are endometriod carcinomas graded?

A

Primarily graded by their architecture

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18
Q

Grade 1 endometriod carcinoma

A

5% or less solid growth

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19
Q

Grade 2 endometriod carcinoma

A

6-50% solid growth

20
Q

Grade 3 endometriod carcinoma

A

> 50% solid growth

21
Q

Stage 1A endometrial carcinoma

A

no or less than 50% myometrial invasion

22
Q

Stage 1B endometrial carcinoma

A

> 50% myometrial invasion

23
Q

Stage II endometrial carcinoma

A

Tumour invades cervical stroma

24
Q

Stage IIIA endometrial carcinoma

A

Tumour invades serosa of uterus and/or adnexae

25
Q

Stage IIIB endometrial carcinoma

A

Tumour invades vagina and/or parametrium

26
Q

Stage IIIC endometrial carcinoma

A

Metastases to pelvic and/or para-arotic lymph nodes

27
Q

Stage IV endometrial carcinoma

A

Tumour invades bladder and/or bowel mucosa (IVA) and/or distant metastases (IVB)

28
Q

This tumour arises from endometrial stroma

A

Endometrial stromal sarcoma

29
Q

Mixed tumour with malignant epithelial and stromal elements

A

Carcinoma (Mullerian tumour)

30
Q

Most important prognostic factor in endometrial stromal sarcoma?

A

Stage

31
Q

Most common place where endometrial stromal sarcoma will metastasise to?

A

Ovary or lung

32
Q

In carcinosarcoma, the presence of a _____ component has the worst prognosis?

A

Rhabdomyosarcomatous

33
Q

Leiomyomata

A

Fibroids (singular: leiomyoma)

34
Q

What is the most common uterine sarcoma?

A

Leiomyosarcoma

35
Q

Cells seen in leiomyosarcoma

A

Spindle cells

36
Q

Endometriod carcinoma precursor?

A

Atypical hyperplasia

37
Q

Serous carcinoma precursor?

A

Serous intraepithelial carcinoma

38
Q

Type 1 Endometrial carcinoma?

A

Endometriod (and mucinous)

39
Q

Type 2 Endometrial carcinoma?

A

Serous (and clear cell)

40
Q

How could granulosa cell tumours present?

A

Precocious puberty, PMB etc (due to oestrogen production by the tumour!)

41
Q

Which ovarian tumour could present with thyrotoxicosis?

A

E.g. a dermoid cyst! (they are totipotential, could contain thyroid tissue, sebaceous material etc etc)

42
Q

How could thecal tumours present?

A

Hirsutism, virilisation (because of androgen production by the tumour!)

43
Q

What type of ovarian tumour in Meig’s syndrome?

A

Fibroma

44
Q

What hormone could malignant germ cells produce?

A

HCG or AFP

45
Q

Exudate seen in ovarian cancer?

A

Malignant ascites with protein exudate

Repodction (52 decks)

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