Uterine Malignancy Flashcards
what are the 3 types of the endometrial hyperplasia
simple
complex
atypical
what form of endometrial hyperplasia is a precursor of carcinoma
atypical
how does endometrial hyperplasia present
abnormal bleeding (dysfunctional uterine bleeding or postmenopausal bleeding)
what is the peak incidence age for endometrial carcinoma
50 - 60 years
what are the 2 types of endometrial carcinoma
Type 1 = Endometrioid carcinoma
Type 2 = Serous carcinoma
what is the precursor to Endometrioid carcinoma
atypical hyperplasia
what is the precursor to serous carcinoma
serous intraepithelial carcinoma
how does endometrial cancer typically present
with postmenopausal bleeding
- scanty and occasional
- may be associated with watery discharge
what cell type are most endometrial carcinomas
adenocarcinoma
what form of endometrial carcinoma is more common
Type 1 = endometrioid carcinoma [80%]
what is endometrial carcinoma related to
unopposed oestrogen
what are the risk factors that play the biggest role in Type 1
obesity
diabetes
who is more likely to get Type 2 Serous tumours
elderly post menopause women
what gene is often mutated in serous (and clear cell) tumours
TP53
what mutations are associated with Type I tumours
PTEN, KRAS, PIK3CA mutations
what is Lynch syndrome
cancer predisposition syndrome - high risk of colorectal, ovarian and endometrialcancer.
what causes Lynch syndrome
inheritance of a defective DNA mismatch repair gene
- autosomal dominant inheritance
how does serous type II tumours progress
spread along Fallopian tube mucosa and peritoneal surfaces
more aggressive than type 1
what is serous carcinoma characterised by
complex papillary and/or glandular archietecture with diffuse, marked nuclear pleomorphism
what is the stage of endometrial cancer
Stage I
- confined to uterus
Stage II
- tumour invades cervical stroma
Stage III
- Local and or regional tumour spread
Stage IV
- tumour invades bladder and/or bowel mucosa and/or distant mets
what rare endometrium cancer is associated with adenomyosis and endometriosis
endometrial stromal sarcoma
how does endometrial stromal sarcoma present
abnormal uterine bleeding + vaginal discharge in younger age group (45-50y/o)
what is a malignant smooth muscle tumour that arises in the myometrium
leiomyosarcoma
