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Isleans Mrcog Part 2 > Oncology > Flashcards

Oncology Flashcards

1
Q

What is meigs syndrome

A

Ovarian mass + right sides right sides pleural effusion

Ovarian tumours that cause meigs: fibroma, thecoma, cytadenom or rarely granulosa cell

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2
Q

Rupture of what type of ovarian cyst may cause pseudomyxoma peritonei and small bowel obstruction

A

Mucinous tumours

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3
Q

Mucinous tumours are associated with which rumour markers

A

CEA and Ca125

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4
Q

Regarding clear cell ovarian carcinoma

What is the cellular origin

A

Mullerian in orginin

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5
Q

Regarding clear cell ovarian carcinoma

What % are bilateral

A

10%

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6
Q

Regarding clear cell ovarian carcinoma

What % are associated with a uterine primary

A

15%

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7
Q

Regarding clear cell ovarian carcinoma

What is the prognosis

A

Poor

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8
Q

Regarding brenner ovarian tumours

What % are benign

If malignant what may they be associated with

A

99%

Bladder tumour

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9
Q

Regarding borderline ovarian tumours

What % are serous in origin

A

50%

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10
Q

Regarding borderline ovarian tumours

What is the 5yr survival at stage I

A

99%

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11
Q

Regarding borderline ovarian tumours

What is the 5yr survival at stage III

A

85%

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12
Q

Describe the features of an ovarian thecoma

A

Usually postmenopausal

Solid, yellow

Almost always benign

Fibroma - meigs syndrome

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13
Q

What ovarian tumour shoes signet rings on histology

A

Krukenburg tumours

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14
Q

Regarding krukenburg tumours

Where can they have metastasised from

A

Stomach, breast, colon

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15
Q

Regarding mature teratomas

What % are bilateral
What % undergo malignant change

A

10-15%

1% malignant change

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16
Q

Regarding krukenburg tumours

What % are bilateral

A

80%

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17
Q

How should ovarian cysts considered low risk be followed up in post menopausal women

A

Ca125 and USS every 3-4 months for 1yr, then discharge back to GP

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18
Q

What are the cut off values for RMI that indicate

Low risk
Moderate risk
High risk

What is the risk of malignancy for each

A

Low risk <25 cancer risk 3%
Moderate risk 25-250 cancer risk 20%
High risk >250 cancer risk 75%

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19
Q

What is the incidence of endometrial cancer in the U.K. Per 100,000 women

A

28:100,000 women

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20
Q

What is the peak age for endometrial Ca

A

70-79yr

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21
Q

Regarding endometrial Ca

What is the % known to be due to lifestyle and other known risk factors

A

37%

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22
Q

Regarding endometrial Ca

What % of those affected are <40yr

A

2-5%

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23
Q

What is lynch syndrome

A

Hereditary non-polyposis colorectal cancer

70% lifetime risk of colon Ca
40-60% lifetime risk of endometrial Ca

Autosomal dominant

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24
Q

What is the lifetime risk of endometrial Ca with lynch syndrome

A

40-60% lifetime risk of endometrial Ca

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25
Q

What is the most common gynaecological cancer in the U.K.

A

Endometrial Ca

26
Q

Regarding endometrial Ca

If the endometrial thickened is <5mm, by how much is the risk of cancer reduced by

A

84%

27
Q

What % of PMB is due to strophic changes

A

45%

28
Q

What % of PMB is due to

Hyperplasia

A

10%

29
Q

What % of PMB is due to polyps

A

15%

30
Q

What imaging should be completed for non-endometroid type endometrial cancer

A

CXR

CT

31
Q

What is the imaging of choice for endometroid endometrial Ca

A

MRI

32
Q

Regarding endometrial Ca

What is the 5 year survival at stage I

A

75%

33
Q

Regarding endometrial Ca

What is the 5 year survival at stage II

A

56%

34
Q

Regarding endometrial Ca

What is the 5 year survival at stage III

A

31.5%

35
Q

Regarding endometrial Ca

What is the 5 year survival at stage IV

A

10%

36
Q

Regarding endometrial Ca

Describe stage I

A

Confined to uterus

A <50%
B>50%

37
Q

Regarding endometrial Ca

Describe stage II

A

Cervical stromal invasion

38
Q

Regarding endometrial Ca

Describe stage III

A

Local &/or regional spread

A serosa/adnexa
B vagina/parametrium
C 1 pelvic LN
C2 paraaortic LN

39
Q

Regarding endometrial Ca

Describe stage IV

A

Invades bladder or rectum &/or distant mets

A bladder/bowel
B distant meta inc inguinal LN

40
Q

Regarding endometrial Ca

What is the treatment for stage I disease

A

If low risk

TAH & BSO

consider laparoscopically if centre with expertise

41
Q

Regarding endometrial Ca

Patients who recur following adjuvant external beam radiotherapy and brachytherapy can be treated again with radiotherapy

True or false

A

False

Once max radical dose of radiotherapy administered the patient cannot be rechallenged with a further radical course of radiotherapy

42
Q

Regarding endometrial Ca

Do stage I is there any benefit from adjuvant radiotherapy

A

No

Overall good prognosis, TAH AND BSO only

43
Q

Regarding endometrial Ca

Where do the majority of recurrences recur

A

Vault or pelvis

44
Q

What is the first line investigation in primary care of a woman with nonspecific symptoms of ovarian Ca

A

Ca125

45
Q

By how much does tamoxifen increase the risk of endometrial Ca

A

3-6x

46
Q

What is the risk that a woman presenting with PMB will have endometrial Ca

A

10-15%

47
Q

Regarding endometrial Ca

Describe stage II

A

Cervical stromal invasion

48
Q

Regarding endometrial Ca

Describe stage IIIa

A

Tumour invades serosa or adnexa

49
Q

Regarding endometrial Ca

Describe stage IIIb

A

Tumour invades vagina and or parametrium

50
Q

Regarding endometrial Ca

Describe stage IIIc1

A

Pelvic node involvement

51
Q

Regarding endometrial Ca

Describe stage IIIc2

A

Para-aortic node involvement

52
Q

Regarding RMI calculation

What is the USS scoring system

A 
1 point for 
Multilocular
Solid areas
Evidence of metastasis
Ascites
Bilateral lesions

0 = 0, 1 = 1, 2-4 = 3

53
Q

Regarding RMI calculation

What is the scoring system for menopause

A 
Premenopausal = 1
Postmenopausal = 3
54
Q

What is the equation for RMI

A

RMI = U x M x ca125

55
Q

Who should treat women deemed at moderate risk of malignancy based on their RMI

A

Lead clinician at a cancer centre

Low risk - general gynaecologist
High risk - gynae oncologist

56
Q

What is the management of older women with no fertility concerns, who had limited surgery, found subsequently to be a borderline ovarian tumour

A

Complete surgical staging

TAH BSO, peritoneal washings, infracolic omentectomy and exploration of the entire abdominal cavity

57
Q

What is systematic retroperitoneal lymphadanectomy

A

Block dissection if LN from pelvic side walls to the level of the renal veins

58
Q

What is optimal surgical staging for ovarian Ca

A

Midline laparotomy, TAH BSO and infracolic omentectomy, biopsies of any perintoneal deposits, random biopsies of the pelvic and abdominal peritoneum and retroperintoneal LN assessment

59
Q

What is the management of women with stage 1 grade 3 ovarian malignancy

A

Adjuvant chemotherapy with 6 cycles of carboplantin

60
Q

What type of HPV is associated with VIN

A

HPV 16

61
Q

What is the 5yr survival of ovarian Ca if stage1

A

90%

62
Q

What is the 5yr survival of ovarian Ca if stage 1c

A

80%

Isleans Mrcog Part 2 (26 decks)

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