Carcinoma

Question 1

Endometrial carcinoma staging surgical

Answer 1

1 - corpus: 1a - no/½ of myometrium involved.
2 - Cervical stroma involved
3a - invades serosa,
3b - invades vagina
3c¹ - +ve pelvic L. Nodes
3c² - +ve paraaortic L. Nodes
4a - bladder and bowel mucosa involved
4b - distant mets

Question 2

Risk factors for Endometrial carcinoma

Answer 2

1. Tamoxifen
2. Anovulatory conditions - PCOS
3. Estrogen Producing tumor - granules cell tumor
4. Early menarche
5. Late menopause
6. Abnormal LFT
7. Obesity
8. CORPUS CANCER SYNDROME
9. Nulliparous
10. Familial Predisposition

Question 3

Protective factors for Endometrial carcinoma

Answer 3

1. Smoking
2. Coffee
3. Exercise
4. Green tea
5. OCPs
6. Multiparity
7. Phytoestrogen

Question 4

Symptoms of CA Endometrium

Answer 4

1. Irregular Noncyclical bleeding
2. Post menopausal bleeding
3. Pyometra- (d/t secretions from cancer glands)
4. Discharge P/V

Question 5

Staging vs grading of Endometrial CARCINOMA

Answer 5

Staging done surgically later the samples are taken for HPE and Graded based on % of solid areas
Grade 1: <5% solid areas
Grade 2: 5- 50% solid areas
Grade 3: >50% solid areas

Question 6

Ca Cervix staging

Answer 6

I - limited to cervix
 A- MICROSCOPIC
  A1- <3mm stromal involvement
  A2- 3-5mm stromal involvement
 B- MACROSCOPIC
  B1- stromal depth >5mm & tumor size <2cm.
  B2- size 2-4cm
  B3- size >4cm
II - involves upper ⅔of vagina
 A- without parametrial involvement
  A1- size <4cm
  A2- size >4cm
 B- with parametrial involvement but not upto the wall.
III - spreads to lower ⅓ of vagina
 A- involves lower ⅓of vagina
 B- involves pelvic wall structures (ureter-hydronephrosis)
 C- lymph node involvement
  C1- pelvic lymph node
  C2- para aortic lymph node
IV- metastasis 
 A- bowel/bladder involvement
 B- distant metastasis