Ch 18: Endometrial Tumors Flashcards Preview

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Flashcards in Ch 18: Endometrial Tumors Deck (8)
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1
Q

A 45 year old female presents with intermenstrual bleeding. Pelvic exam does not reveal any abnormalities, but on ultrasound you notice an endometrial mass in the fundus. The pathology report states: “Cystically dilated and hyperplastic endometrial glands with fibrous endometrial stroma; No atypia noted”. What is the most likely diagnosis?

A

Dx: Endometrial Polyp

2
Q

A 59 year old female presents with uterine bleeding. Upon further work-up you diagnose endometrial hyperplasia. Your patient then asks, “what causes this?”. How do you respond?

A

Dx: Endometrial Hyperplasia

EH is a result of unopposed estrogen (Obesity, PCOS, estrogen replacement)

It can result in simple, complex, or atypical hyperplasia, with atypia being the most important predictor of progression to carcinoma.

3
Q

A 32 year old female presents to you with concerns of having uterine cancer. She has read a lot on the internet about various types of endometrial cancer, and asks you, “what is the difference between EIN and endometrial hyperplasia?”

A

Endometrial hyperplasia is considered a polyclonal pathology where all endometrial cells are acted upon and proliferate. EIN is seen as a monoclonal pathology consisting of monoclonal neoplastic growths of genetically altered cells that have an increased risk of becoming endometroid endometrial adenocarcioma.

4
Q

You diagnose a patient with endometrial adenocarcinoma. What are risk factors for this type of cancer and in what population does it usually occur?

A

Occurs mainly in pre- or perimenopausal women and is associated w/ obesity, hyperlipidemia, anovulation, infertility, and late menopause

5
Q

A patient with an endometrial mass undergoes biopsy. You catch a glimpse of the pathology report and see “Psammoma bodies”. What is the most likely diagnosis? What 4 types of cancer do you see psammoma bodies in?

A

Dx: Serous adenocarcioma of the endometrium

1- Meningioma
2- Papillary Carcinoma of the thyroid
3-Serous carcinoma of ovary/endometrium
4-Mesothelioma

6
Q

A 34 year old female patient presents with abnormal uterine bleeding and a pelvic mass. On biopsy there is little mitotic activity, no nuclear atypia, and the mass was said to be a “white-whorled” well-defined mass. What is the most likely diagnosis?

A

Dx: Leiomyoma (Fibroid)

Most common tumor of female genital tract and there are often multiple lesions, not just one.

7
Q

A 37 year old female presents with abnormal uterine bleeding. A mass is found and biopsy shows Leiomyosarcoma. How does this differ from a leiomyoma? And what population is it most likely seen in?

A

Usually present as a single mass with hemorrhage and necrosis. They often show nuclear atypia with lots of mitoses. This is usually seen in POSTmenopausal women.

8
Q

A 45 year old female presents to you with an endometrial mass later determined to be endometrial adenocarcinoma. What gene is usually implicated in the tumorigenesis of this lesion?

A

PTEN tumor suppressor gene

(ptENdometrial carcinoma)

Usually a result of deletion, mutation, and/or promoter hypermethylation