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Reproduction > Uterine Malingancy > Flashcards

Uterine Malingancy Flashcards

1
Q

When looking at a pathology report you see that your patient has atypical hyperplasia of the uterus. What specific condition is this a precursor for?

A

Endometriod carcinoma

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2
Q

When looking at a pathology report you see that your patient has serous intraepithelial carcinoma of the uterus. What specific condition is this a precursor for?

A

Serous carcinoma

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3
Q

What condition must you look for in overweight women with PMB?

A

Endometrial carcinoma

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4
Q

Which type of endometrial cancer is associated with unopposed oestrogen?

A

Endometriod and mucinous

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5
Q

Which type of endometrial cancer is not associated with unopposed oestrogen?

A

Serous and Clear cell

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6
Q

Why does obesity increase the risk of endometrial cancer?

A

Adipocytes express aromatase with converts ovarian androgens into oestrogens which induce endometrial proliferation

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7
Q

What syndrome predisposes you to colorectal cancer and ovarian cancer?

A

Lynch syndrome

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8
Q

What mode of inheritence is seen in lynch syndrome?

A

Autosomal dominant

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9
Q

What gene mutation is seen in serous and clear cell cancer of the endometrium?

A

TP53

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10
Q

What is the difference between simple and atypical endometrial hyperplasia?

A

Simple hyperplasia is usually generalised where as atypical is usually localised

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11
Q

Which is more dangerous is endometrial hyperplasia; cytological or architechtural abnormaility?

A

Cytological. These have a greater malignant potential.

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12
Q

What stage is this endometrial cancer; Confined to the uterus with less than 50% of the myometrium being invaded?

A

Stage 1A

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13
Q

What stage is this endometrial cancer; Confined to the uterus with more than 50% of the myometrium being invaded?

A

1B

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14
Q

What stage is this endometrial cancer; Invasion into the cervical stroma?

A

2

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15
Q

What stage is this endometrial cancer; Involvement of pelvic lymph nodes?

A

3

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16
Q

What stage is this endometrial cancer; Invasion into the vagina?

A

3

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17
Q

What stage is this endometrial cancer; Invasion into the serosa of the uterus?

A

3

18
Q

What stage is this endometrial cancer; Invasion of the bladder?

A

4

19
Q

What stage is this endometrial cancer; Invasion of the rectum?

A

4

20
Q

What stage is this endometrial cancer; brain mets?

A

4

21
Q

What is the peak incidence of endometrial carcinoma?

A

50 - 60 years

22
Q

What type of uterine cancer is atypical hyperplasia a precursor for?

A

Endometriod

23
Q

What type of cancer is serous intraepithelial carcinoma a precursor for?

A

Serous carcinoma

24
Q

How does endometrial carcinoma generally present?

A

Abnormal bleeding

25
Q

How are endometriod carcinoma generally graded?

A

By their architechture
Grade 1: 5% or less solid growth
Grade 2: 6 - 50% solid growth
Grade 3: Over 50% solid growth

26
Q

What is the most common presentation of endometrial stromal sarcoma?

A

Abnormal uterine bleeding

But can also present with metastases

27
Q

Which endometrial tumour is a mixture of epithelial and mesenchymal components?

A

Carcinosarcoma

28
Q

What name is given to a malignant tumour of smooth muscle?

A

Leiomyosarcoma

29
Q

What is the most common type of endometrial carcinoma?

A

Endometriod carcinoma

30
Q

What grade is this endometrial cancer: Well differentiated lesions with 98% glandular formations

A

Grade 1

31
Q

What grade is this endometrial cancer: 48% solid areas

A

Grade 2

32
Q

What grade is this endometrial cancer: More than 50% solid lesions

A

Grade 3

33
Q

What is the best imaging modality for assessing the degree of myometrial invasion in endometrial cancer?

A

MRI

34
Q

Describe simple uterine hyperplasia

A

Glands of various sizes, most cystic
No crowding of glands
Small mitotic figures

35
Q

Describe complex uterine hyperplasia

A

Crowding of glands
Stratified epithelium with more mitotic figures
No atypia

36
Q

Describe atypical uterine hyperplasia

A

Nuclear atypia is present
Abnormal mitotic figures
Glandular polypoid formations

37
Q

How is simple uterine hyperplasia treated?

A

No routine follow up

If patients are symptomatic progesterone agents might help wither orally or via the mierna IUS

38
Q

What is the risk of progression to endometrial cancer if you have simple uterine hyperplasia?

A

1%

39
Q

How is complex uterine hyperplasia treated?

A

Progesterone therapy with mirena coil

40
Q

What is the risk of progression to endometrial cancer if you have atypical uterine hyperplasia?

A

20 - 50%

41
Q

How is atypical uterine hyperplasia treated?

A

Hysterectomy with bilateral salpingo oophrectomy

Reproduction (40 decks)

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