Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproductive System > Session 11: Tumours of the Reproductive Tracts NOT FINISHED > Flashcards

Session 11: Tumours of the Reproductive Tracts NOT FINISHED Flashcards

1
Q

Where might you find tumours in the female reproductive tracts?

A

Vulva

Cervix

Endometrium

Myometrium

Ovaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a tumour?

A

Any clinically detectable lump or swelling. A neoplasm is just one type of tumour.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a neoplasm?

A

An abnormal growth of cells that persists after the initial stimulus is removed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a malignant neoplasm?

A

An abnormal gorwth of cells that persists after the initial stimulus is removed and invades surrounding tissue with potential to spread to distant sites.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Most common vulval cancers.

A

Squamous cell carcinoma (90%)

Basal cell carcinoma

Melanoma

Soft tissue tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Clinical features of vulval cancers.

A

Lumps

Ulceration

Skin changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What might you find upon histological investigation of squamous cell carcinoma of vulva?

A

Atypical squamous cells and keratin formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is vulval intraepithelial neoplasia a potential precursor of?

A

Squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the main causative factor of squamous cell carcinoma of the vulva in pre-menopausal women?

A

HPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where does the SCC spread?

A

Direct to anus, vagina and bladder

Lymph nodes such as inguinal, iliac and para-aortic

Distant metastases to lung and liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the causative agent of vulval squamous cell carcinoma in older women?

A

Not known but probably related to chronic irritation and long standing dermatoses such as lichen sclerosus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is dysplasia?

A

A pre-neoplastic alteration in which cells show disordered tissue organisation.

It is not neoplastic because the change is reversible.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What type of cancer is most common of the cervix?

A

Squamous cell carcinomas (80%)

15% are adenocarcinomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most common causative agent of cervical cancer.

A

Almost exclusively HPV (99.5%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does squamous cell carcinoma develop from?

A

Cervical intraepithelial neoplasia (CIN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Explain how HPV causes cancer of the cervix.

A

Infect the transformation zone

Produce viral proteins E6 and E7 that inactivate TSGs p53 and Rb.

This leads to uncontrolled cellular proliferation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Risk factors for CIN and cervical carcinoma

A

Increased risk of exposure to HPV such as sexual partner with HPV, multiple partners or early age of first intercourse.

Early first pregnancy

Multiple births

Smoking

Low socio-economic status

Immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment for CIN

A

Depends on which stage of CIN.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment of CIN1.

A

Most commonly regress spontaneously but is followed up by a cervical smear in 1 year time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment of CIN 2&3.

A

Needs treatment and is done by large loop excision of transformation zone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the cervical screening programme?

A

Brush is used to scrape cells from the transformation zone to detect abnormally enlarged nuclei possessing abnormal chromatin. If this is positive there is referral to colposcopy.

You also test for HPV.

Aged 25-49 = every 3 years

Aged 50-64 = every 5 years

Over 65 = only if recent abnormality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is vaccination against HPV?

A

Given in girls aged 12-13 and becomes more common in boys as well.

Protects from cervical, vulval, oral and anal cancers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do carcinomas of cervix spread?

A

Spreads initially to iliac and aortic lymph nodes before wider systemic dissemination.

Spread locally to ureters, bladder, and rectum.

Can be extremely distressing with pain and fistula formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Clinical presentation of invasive cervical cancer.

A

Bleeding post coital, intermenstrual and post menopausal.

Mass felt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Treatment of invasive cervical cancer.

A

Hysterectomy

Lymph node dissection

+/- chemoradiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What types of endometrial cancers are there?

A

Endometrioid adenocarcinoma

Serous adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What does endometrioid adenocarcinoma commonly arise from?

A

Endometrial hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which age group is generally affected by endometrioid adenocarcinoma?

A

Perimenopausal and older women.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Aetiology of endometrial adenocarcinoma in perimenopausal women.

A

Unopposed oestrogen from obesity, exogenous oestrogen administration like HRT.

Tamoxifen

Hormone-secreting tumour

Polycystic ovarian syndrome

Early menarche/late menopause (longer exposure to oestrogen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How can obesity cause a higher risk of endometrial hyperplasia and endometrial adenocarcinoma?

A

Peripheral adipocytes cause conversion of androgen to oestrogen leading to higher oestrogen levels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Clinical presentation of endometrial cancer.

A

Bleeding that is post menopausal.

Intermenstrual bleeding

Mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How do serous adenocarcinomas differ to endometrioid carcinoma?

A

Serous are less common and more aggressive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the spread of endometrioid adenocarcinoma?

A

Cervix, bladder and rectum.

Through the peritoneal cavity and to the regional lymph nodes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Spread of serous adenocarcinoma.

A

Travels through fallopian tubes.

Deposits on peritoneal surface via transcoelomic spread.

Associated with collections of calcium called psammoma bodies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Management of endometrial cancer.

A

Hysterectomy

Bilateral salpingo-oophorectomy

+/- lymph node dissection

+/- chemoradiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are fibroids?

A

Leiomyoma which are the most common of the myometrium and benign.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Symptoms of fibroids

A

Heavy menstrual loss, menorrhagia and infertility

38
Q

Appearance of fibroids.

A

Pale, homogenous, well circumscribed mass

39
Q

What can fibroids cause?

A

Massive uterine enlargement and this results in pressure symptoms in the pelvis.

The growth is oestrogen dependent and they usually regress after the menopause.

40
Q

What is a malignant tumour of the myometrium?

A

Leiomyosarcoma

41
Q

Do leiomyosarcomas arise from leiomyomas?

A

No

42
Q

Metastases of leiomyosarcoma.

A

Spread via blood stream to the lungs

43
Q

Presentation of ovarian cancer.

A

Vague and non-specific.

Later symptoms like abdo pain, abdo distension, urinary symptoms and GI symptoms due to mass effect.

Hormonal disturbances

44
Q

Give types of ovarian tumours.

A

Surface epithelium (epithelial tumours)

Germ cell tumours

Sex-cord stromal tumours

45
Q

What are the majority of ovarian tumours?

A

Epithelial tumours

46
Q

Serum marker of ovarian cancer.

A

Ca-125

47
Q

Cause of ovarian epithelial carcinoma.

A

BRCA1/2 which are TSGs associated with high grade serous cancers.

48
Q

What are the histological subtypes of ovarian epithelial tumours.

A

Serous

Mucinous

Endometroid

All adenocarcinomas

All can be benign, borderline or malignant

49
Q
A

Ovarian serous adenocarcinoma with highly atypical cells often show psammoma bodies.

Often spreads to the peritoneal cavity

50
Q
A

Ovarian mucous adenocarcinoma showing atypical cells secreting mucin.

51
Q
A

Ovarian endometrioid adenocarcinoma

Glands resembling endometrium and may arise in endometriosis.

52
Q

Most common female germ cell tumour.

A

Teratoma

53
Q

Three subtypes of teratoma

A

Mature

Immature

Monodermal

54
Q

What do mature teratomas (dermoid cyst) look like on histology?

A

Contain fully mature differentiated tissue from all germ cells layers.

Often contains skin + hair

55
Q

What does the presence of immature tissue such as primitve neuroepithelium indicate?

A

Malignancy and a risk for intra-abdominal spread.

56
Q

Give other malignant germ cell tumours.

A

Dysgerminomas which are the equivalent of seminoma in testis.

Choriocarcinoma

Embryonal carcinoma

Yolk sac tumour

57
Q

Useful tumour markes in malignant germ cell tumours.

A

Alpha-fetoprotein (AFP)

beta-human chorionic gonatrophin (hCG)

58
Q

Sex cord stromal tumours in testes

A

Sertoli cell tumour

Leydig cell tumour

59
Q

Sex cord stromal tumours in ovaries.

A

Granulosa cells

Theca cells

60
Q

What do granulosa cell tumours produce?

A

Oestrogens that may be responsible for endometrial hyperplasia and adenocarcinoma as it can lead to endometroid adenocarcinoma.

61
Q

What do sertoli-leydig cell tumours produce?

A

Androgens that can cause defeminisation, masculinisation, amenorrhoea and infertility.

62
Q

What might theca and granulosa cell tumours cause in a patient pre-puberty?

A

Precocious puberty

63
Q

What might theca and granulosa cell tumours cause in a patient post-puberty?

A

Breast cancer

Endometrial hyperplasia

Endometrial carcinoma

64
Q

What might Sertoli-Leydig cell tumours cause in a patient pre-puberty?

A

Prevents normal female pubertal changes

65
Q

What might Sertoli-Leydig cell tumours cause in a patient post-puberty?

A

Sterility

Amenorrhoea

Hirsuitism

Male pattern baldness

Breast atrophy

66
Q

Common cancers metastasising to ovaries.

A

Breast cancer

Gastrointestinal cancers

Krukenberg tumour (metastatic GI tumour)

Other gynae tumours endometrial, other ovary, fallopian tube

67
Q

When in men are tumours of the testis most common?

A

Aged 15-34

68
Q

What can testicular tumours be classified as?

A

Germ cell tumours

Sex-cord stromal tumours

69
Q

What are the most common sex cord stromal tumours in men?

A

Sertoli or Leydig cell tumours

70
Q

Are sex cord-stromal tumours malignant or benign?

A

Benign and also very uncommon

71
Q

What are the most common testicular tumours?

A

Germ cell tumours (they are also all malignant)

72
Q

Risk factors of testicular cancer.

A

Cryptorchidism which is an undescended testicle.

That’s why it is important to ask for medical history

73
Q

Presentation of testicular cancer.

A

Mass

Usually painless testicular mass but might be painful.

74
Q

What is the pre-invasive precursor of germ cells tumours?

A

Intratubular germ cell neoplasia

75
Q

What can germ cell tumours be divided into?

A

Seminomas

Non-seminomatous germ cells tumours (NSGCTs)

76
Q

What percentage of germ cell tumours are seminomas?

A

50%

77
Q

Peak age of seminomas

A

40-50 yrs of age

78
Q

What can pure NGSCTs be classified as?

A

Yolk sac tumours

Embryonal carcinomas

Choriocarcinomas

Teratomas

However most NSGCTs are mixed

79
Q

Yolk sac tumours

A

Occur in young children and have very good prognosis

80
Q

Investigations of testicular cancers

A

Scans and tumour markers

81
Q

What do yolk sac tumours produce?

A

AFP

82
Q

Embryonal carcinomas, choriocarcinomas, and mixed NGSCTs

A

Occur in young adults

83
Q

What do choriocarcinomas produce?

A

beta-human chorionic gonadotropin (hCG)

84
Q

What do mixed NSGCTs produce?

A

AFP and hCG

85
Q

Teratomas in men

A

Occur in all ages. Arise in prepubertal then usually benign, if in postpubertal always malignant.

86
Q

Seminomas

A

10% are also associated with raised serum hCG.

87
Q

Spread of seminomas

A

Remain confined to the testis for long periods of time. However when they do metastasise it is by the lymphatics and most commonly to the iliac and paraortic lymph nodes.

Further spread is rare.

88
Q

Spread of NSGCTs.

A

Tend to metastasise early and do so via both lympathics and blood. The primary tumour might even be non-palpable.

89
Q

Treatment of testicular tumours.

A

Radical orchiectomy

90
Q

Further treatment of testicular tumours

A

Depends on whether the tumour is seminoma or NSGCT.

91
Q

Further treatment of a seminoma.

A

Radiosensitive and treated therfore with radiotherapy.

92
Q

Further treatment of NSGCTs.

A

Aggressive chemotherapy

Reproductive System (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions