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Flashcards in Gyn Onc Deck (31)
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1

Point A for Radiotherapy for carcinoma of the cervix. How much Rads for local advanced disease?

2 cm above level of external os and 2cm lateral to the midline (point of crossover of artery over ureter)

2

Point B for Radiotherapy for carcinoma of the cervix. How much Rads?

3 cm lateral to point A (position of obturator nodes) Aim to deliver 5500 to 6500. Rads to Point B depending on the extent of parametrial/sidewall disease

3

High risk HPV subtypes

16, 18, 31, 33, 35, 45

4

Describe the histological architecture of Endometrial Intraepithelial Neoplasia (EIN)

Increased glandular density w/ atypia

5

Risk of malignancy w/ Endometrial Intraepithelial Neoplasia (EIN)

formerly simple/complex hyperplasia w/ atypia (formerly 10/30%)

30-50%

6

Types of Endometrial Cancer

Type I- Endometriod, 75% of endometrial cancer, global process, unopposed estrogen, better prognosis

Type II- Clear Cell, Papillary Serous. High grade, poorer prognosis, more focal in origination

7

How is staging for uterine cancer performed?

Surgical staging-remove uterus, cvx, adnexa, pelvic and para aortic nodes and pelvic washings

8

One of most important prognostic factors for endometrial carcinoma?

Presence of extra uterine disease

9

What percent of patients w/ surgery for an atypical endometrial hyperplasia will have an endometrial cancer at final pathology?

40% of patients

10

Criteria for patient selection for Medical Management of Endometrial Carcinoma?

1. Pre-menopausal w/ strong desire to preserve uterus for fertility
2. Poor candidate for major operation due to medical co-morbidities

11

Medical Management of Endometrial Cancer

1. Medroxyprogesterone or Megestrol
2. Progesterone-containing IUD

Should be prescribed by Gyn Onc

12

Differential Dx of Solid Ovarian Tumor

Fibroid
Thecoma
Fibroma
Fibrothecoma
Brenner
Granulosa Cell Tumor
Dysgerminoma

13

Differential Dx of Cystic Tumors

Fx Cysts
Serous Cysts
Mucinous Cysts
Mature cystic teratoma

14

Bilaterality of Germ cell tumors

5-10% (teratoma)
Exception=gonadoblastoma (40%)

15

Bilaterality of Fibroma

10%

16

B/L of Serous carcinoma

66%

17

B/L of Mucinous carcinoma

20%

18

B/L of Krukenburg

100% ( from GI tract )

19

B/l of Mucinous adenoma

0% (virtually)

20

B/l of Serous adenoma

10%

21

CA-125

Serous epithelial tumors

22

False + CA-125

Appendicitis
Cholecystitis
PID
Fiborids
Endometriosis
Diverticulosis

23

CEA

Mucinous epithelial tumors

24

AFP

Endodermal sinus tumors
Embryonal tumors
Germ Cell Tumors

25

HCG

Choriocarcinoma
Embryonal Sinus tumor
Germ cell tumors

26

Estrogens

Granulosa Cell tumor

27

Androgens

Thecoma
Fibroma
Sertoli-Leydig cell tumor

28

Inhibin

Granulosa cell tumor

29

LDH

Dysgerminoma

30

Criteria for borderline tumors

Epithelial stratification
Papillations
Nuclear atypia
No stromal invasion

31

Dysgerminoma

Typically young, nullip
Treat with USO, limited staging, conserve contralateral Ov and uterus, Follow with LDH, HCG tumor markers.