Uterine Malignancy Flashcards
list common causes of post menapausal dysfunctional uterine bleeding?
- Endometrial or cervical polyps
- Endometrial hyperplasia
- Simple
- Complex
- Atypical (precursor of carcinoma)
1 in 10 cases endometrial cancer
inflammation and thinning of the vaginal lining (atrophic vaginitis) or womb lining (endometrial atrophy) – caused by lower oestrogen levels
How do simple/ complex and atypical hyperplasia differ?
In Simple hyperplasia glands are dilated wheras in Complex and Atypical glands are crowded
In Atypical hyperplasia Cells are atypical
when is the peak incidence of endometrial carcinoma?
Peak incidence 50 ‐ 60 years; uncommon under 40
what are risk factors for developing endometrial carcinoma
PCOS
Lynch Syndrome
Obesity
what are the two main types of endometrial carcinoma?
What are their precursor lesions?
What Genetic mutations are they associated with?
. Endometrioid (and mucinous) – type 1 tumours (80%)
- Related to unopposed oestrogen
- Associated with atypical hyperplasia
PTEN, KRAS, PIK3CA, Lynch Syndrome
- Serous (and clear cell) – type 2 tumours (More aggressive)
– Serous carcinoma: precursor serous intraepithelial carcinoma
- Not associated with unopposed oestrogen
- Affect elderly post‐menopausal women
- TP53 often mutated
how are endometroid cancers graded?
Grade 1 5% or less solid growth
Grade 2 6-50% solid growth
Grade 3 >50% solid growth
describe the grading of endometrial tumours
Stage I Tumour confined to the uterus
IA no or < 50% myometrial invasion
IB Invasion equal to or > 50% of myometrium
II Tumour invades cervical stroma
III Local and or regional tumour spread
IIIA Tumour invades serosa of uterus and/or adnexae
IIIB Vaginal and/or parametrial involvement
IIIC Metastases to pelvic and/or para-aortic lymph nodes
IV Tumour invades bladder and or bowel mucosa (IVA) and/or distant metastases (IVB)
name other endometrial cancers?
- Carcinosarcoma
- Endometrial stromal sarcomas
- Leiomyosarcoma
