Flashcards in Ch 18: Endometrial Tumors Deck (8)
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?
Dx: Endometrial Polyp
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?
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.
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?"
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.
You diagnose a patient with endometrial adenocarcinoma. What are risk factors for this type of cancer and in what population does it usually occur?
Occurs mainly in pre- or perimenopausal women and is associated w/ obesity, hyperlipidemia, anovulation, infertility, and late menopause
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?
Dx: Serous adenocarcioma of the endometrium
2- Papillary Carcinoma of the thyroid
3-Serous carcinoma of ovary/endometrium
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?
Dx: Leiomyoma (Fibroid)
Most common tumor of female genital tract and there are often multiple lesions, not just one.
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?
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.