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DM 2 - Gynecology > Uterine Pathologu > Flashcards

Uterine Pathologu Flashcards

1
Q

What imaging modality can assist with pre surgical staging?

Uterine cancer

A

MRI

  • myometrial invasion
  • cervical extension
  • parametrial involvement
  • lymph nodes
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2
Q

Stage 1A endometrial

A

Confinded to the corpus

<50% myometrium

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3
Q

Stage 1B

A

Limited to corpus

> /= 50%

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4
Q

Stage 2

A

Tumor invades cervical stroma but not beyond uterus

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5
Q

Stage 3A

A

Tumor Invades serosa +/- adnexa

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6
Q

Stage 3B

A

Vaginal involvement +/- parametrium

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7
Q

Stage 3C1

A

Positive pelvic nodes

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8
Q

Stage 3C2

A

Positive paraaortic nodes +/- pelvic

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9
Q

Stage 4A

A

Bladder +/- bowel mucosa

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10
Q

Stage 4B

A

Distand metastasis

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11
Q

Grade 1 disease

A

<5% nonsquamous or nonmorular solid growth pattern

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12
Q

Grade 2

A

6-50% nonsquamous or nonmorular solid growth

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13
Q

Grade 3

A

> 50% nonsquamous or nonmorular

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14
Q

What are the characteristics if high risk disease?(5)

A
  • grade 3 tumor
  • lymphovascular space invasion
  • non endometriod histology( serous, clear cell, undifferentiated etc)
  • cervical stromal involvement
  • p53 molecular type
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15
Q

What imaging modalities are used to assess for recurrent disease?(2)

A
  • CT
  • FDG-PET/CT
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16
Q

What is the most common site of recurrence?

A

Vaginal cuff

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17
Q

Incidence of endometrial cancer

A

28 : 100,000

9000 new cases per year (UK)

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18
Q

Peak age of diagnosis

A

60-79 yo

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19
Q

What percentage is due to lifestyle and other known risk factors?

A

34%

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20
Q

Since the 1990s, mortality from endometrial cancer has increased or decreased?

A

Increased by 25%

21
Q

What surgery would you perform for a grade 1 stage 1a endometriod adenocarcinoma

A

Total laparoscopic hysterectomy and bilateral salpingo-oophrectomy

22
Q

Increasing incidence is due to what factors ? (3)

A
  • obesity
  • nulliparity
  • aging population
23
Q

What is the effect of parity on the incidence of endometrial cancer?

A

Nulliparity- increase (35-40% of cases are nulliparous)

Para 1- reduces risk by 30%

Para 2+ - additional 25% per pregnancy

24
Q

Effect of estrogen HRT on endometrial CA?

A

2.3 times higher than non users

25
Q

PCOS and endometrial ca

A

2.8 times higher than normal females

26
Q

How does type 2 diabetes impact endometrial ca

A

40-80% increased risk
(Link possibly due to obesity and not directly to DM)

27
Q

Risk of endometrial cancer with LYnch syndrome

A

40-60%

28
Q

What ate protective factors against endometrial cancer (4)

A
  • cigarette smoking (20-40%)
  • COCP (25%)
  • coffee intake (21%)
  • exercise (15-25%)
29
Q

Overall 5 year survival of endometrial cancer

A

80%

30
Q

5 year survival stage 1 EC

A

85-90%

31
Q

5 year survival stage 2 EC

A

75%

32
Q

5 year survival stage 3 EC

A

45%

33
Q

5 year survival stage 4 EC

A

<30%

34
Q

What is the risk association if endometrial cancer and Cowden syndrome

A

30% life time risk

35
Q

Types of uterine sarcomas (5)

A

1- leiomyosarcoma
2- endometrial stromal
3- undifferentiated uterine sarcoma
4- carcinosarcoma
5- mesenchymal

36
Q

What is the most common uterine sarcoma

A

Leiomyosarcoma (60%)

37
Q

What are the highest combination factors for developing endometrial cancer in patients with PMB

A
  • PMB
  • obesity
  • diabetes

Total risk 29%

38
Q

What is the overall risk of endometrial ca with PMB

A

10%

39
Q

What is the risk of endometrial ca with PMB @ <50yrs old

A

1%

40
Q

What percentage of patients with PMB have endometrial or cervical polyps

A

25%

Asymptomatic polyps 11.8%

41
Q

Risk of malignancy withing an endometrial polyp

A

3%

42
Q

Risk factors for malignant change of an endometrial polyp

A
  • size >10mm
  • menopause
  • aub
43
Q

Prevalence of atypia within a polyp

A

0.8%

44
Q

What is the risk of malignant progression of hyperplasia without atypia

A

<5% over 20 years

45
Q

What is the surveillance of EH without atypia on hormonal mx

A

6mnthly endometrial biopsy until 2 negative samples

46
Q

What is the risk of malignant progression with EH with atypia

A

25-30% in 10 years

47
Q

Risk.of endometrial CA if endometrial stripe 4mm or less

A

<1%

48
Q

What percentage of endometrial ca is genetic

A

2-5%

49
Q

What percentage of patients with a granulosa tumor will have endometrial cancer

A

10-15%

1:3 have hyperplasia

DM 2 - Gynecology (22 decks)

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