Cancers

Question 1

What type are most vulval cancers

Answer 1

Squamous carcinoma

Question 2

What is the main cause of vulval cancer in pre-menopausal women

Answer 2

HPV

Question 3

How do vulval tumours normally spread

Answer 3

Local and lymphatic to inguinal

Question 4

What is removed in definitive surgery for vulval cancer

Answer 4

Primary tumour and nodes

Question 5

Vulval intraepithelial neoplasia is cured by

Answer 5

Excision

Question 6

What are most cervical carcinomas

Answer 6

Squamous cell

Question 7

What other carcinoma can cervical cancer be

Answer 7

Adenocarcinoma

Question 8

What common aetiology of cervical cancer

Answer 8

HPV

Question 9

What is the precursor to SCC in cerivcal

Answer 9

CIN

Question 10

What does cervical screening detect

Answer 10

Enlarged nuclei with abnormal chromatin

Question 11

What age is the HPV vaccine offered to girl

Answer 11

12-13
6&11
16&18

Question 12

How does carcinoma in cervix spread

Answer 12

Iliac then aortic nodes then wider dissemination

Can be local spread to bladder, ureters, rectum

Question 13

Who mostly gets endometrial adenocarcinoma

Answer 13

Perimenopausal and older women

Question 14

What is the biggest cause in perimenopausal women

Answer 14

Unopposed oestrogen from obesity, exogenous oestrogen administration and hormone secreting tumour

Question 15

Why is tamoxifen implicated in endometrial tumours

Answer 15

Causes increased stimulation of oestrogen receptors whilst suppressing breast oestrogen receptors

Question 16

What does unopposed oestrogen cause

Answer 16

Endometrial hyperplasia then endometrioid endometrial adenocarcinoma

Question 17

Other type of endometrial adenocarcinoma

Answer 17

Serous

Less common but more aggressive

Question 18

What are benign tumours of the uterine smooth muscle

Answer 18

Fibroids- leiomyomas

Question 19

Symptoms of fibroids

Answer 19

Heavy menstrual bleeding
Menorrhagia
Infertility
Compression if big

Question 20

Why do fibroids grow

Answer 20

Oestrogen dependent

Question 21

What is malignant tumors of myometrium called

Answer 21

Leiomyoscarcoma

Question 22

What metastasis is common with leiomyoscaroma

Answer 22

Lungs

Question 23

What are the three origin of ovarian cancer

Answer 23

Germ cell
Epithelium
Sex cord-stromal

Question 24

What are the majority of ovarian cancers

Answer 24

Epithelial

Question 25

What are the three subtypes of ovarian epithelial tumours

Answer 25

Serous Mucinous Endometriod

Question 26

What are the three classifications of ovarian cancer

Answer 26

Benign Borderline Malignant

Question 27

What is the prognosis of malignant ovarian epithelial tumours

Answer 27

Poor | Spread late

Question 28

What spread do ovarian epithelial cancers do

Answer 28

Transcoelomic

Question 29

How do ovarian endometrial tumours that have metastasise present

Answer 29

Ascites, intestinal obstruction and death

Question 30

Are ovarian germ cell tumors normally benign or malignant

Answer 30

Benign

Question 31

What is the most common type of germ cell tumour

Answer 31

Mature cystic teratoma- dermoid cyst

Question 32

What a characteristic of dermoid cyst

Answer 32

Tissue from three germ layers

Question 33

What does the presence of immature tissue indicate

Answer 33

This is neuroepithelium and indicates malignancy

Question 34

What are the other types of malignant germ cell tumours

Answer 34

Dysgerminoma Yolk sac Choriocarcinoma Embryonal carcinoma

Question 35

What markers are useful to detect malignant germ cell carcinomas

Answer 35

Alpha fetoprotein and beta hCG

Question 36

What tissue sex cord stromal tumours derived from

Answer 36

Ovarian stroma which is derived from sex cord of embryonic gonad

Question 37

What do sex cord stromal tumours normal produce

Answer 37

Oestrogens = endometrial hyperplasia and adenocarcinoma and iso sexual precocious puberty

Question 38

What can sertoli leydig cell tumours cause

Answer 38

Produce androgens and cause defeminisation, masculinisation, amenorrhoea, infertility

Question 39

What are kruckenberg tumours

Answer 39

Metastatic gastrointestinal tumours metastasis to ovaries from stomach

Question 40

What is the most common age for testicular tumours

Answer 40

15-34

Question 41

What are testicular tumours classified as

Answer 41

Germ cell or sex cord stromal

Question 42

What is the most common sex cord stromal tumours seen is testes

Answer 42

Sertoli or leydig- benign

Question 43

What makes up 95% of testicular tumours in postpubertal males

Answer 43

Germ cell | Malignant

Question 44

What is aetiology of germ cell tumours

Answer 44

Familial Cancer in one testes Cryptorchidism and hence orchiopexy - affects both testes

Question 45

How does testicular cancer usually present

Answer 45

Painless mass

Question 46

What is intratubular germ cell neoplasi

Answer 46

Pre invasive precursor of germ cells

Question 47

What are the two groups of germ cell tumours in testicular cancer

Answer 47

Seminomas | Non seminomatous germ cell tumours

Question 48

What is the peak age for seminoma

Answer 48

40-50

Question 49

What are the pure NSGCT classification

Answer 49

Yolk sac Embryonal carcinoma Choriocarcinoma Teratoma

Question 50

When are yolk sac tumours common

Answer 50

Young children | Good prognosis

Question 51

How are yolk sac tumours detected

Answer 51

Yolk sac tumours produce alpha fetoprotein- blood tumour marker

Question 52

When do embryonal carcinomas, choriocarcinoma and mixed NSGCTs occur

Answer 52

Young adults

Question 53

What are all choriocarcinomas associated with

Answer 53

Elevated serum beta hCG

Question 54

What are mixed NSGCTs associated with

Answer 54

Elevated AFP and hCG

Question 55

When can teratomas arise

Answer 55

All ages

Question 56

When are teratomas benign or malignant

Answer 56

Benign- prepubertal | Malignant- postpubertal

Question 57

What % of seminomas are associated with elevated hCG

Answer 57

10%- the syncytiotrophoblastic cells

Question 58

What are the characteristics of seminomas

Answer 58

Confined to testis for long periods of time Metastasis Via lymphatics- iliac and para aortic Further spread is rare

Question 59

What are the characteristics of NSGCTs

Answer 59

Metastasis early Lymphatics and blood vessels Can metastasise before palpable

Question 60

How are testicular tumours treated

Answer 60

Radical orchiectomy

Question 61

How are seminomas treated

Answer 61

Very responsive to radio

Question 62

What germ cell tumour has best prognosis

Answer 62

Seminoma

Question 63

How are NSGCTs treated after surgery

Answer 63

Aggressive chemo

Question 64

Why are tumour markers tested after surgery

Answer 64

Response to therapy