gynae

Question 1

post-menopausal bleeding is X until proven otherwise

Answer 1

endometrial cancer

Question 2

most common type of endometrial carcinoma?

Answer 2

adenocarcinoma (85%)
-squamous cell carcinoma (15%)

Question 3

how is endometrial adenocarcinoma subdivided?

Answer 3

-endometrioid (80%) looks similar to normal endometrial glands
-non-endometrioid (20%)

Question 4

features of endometrioid adenocarcinoma?

Answer 4

-low grade, supeficial
-secretory, endometrioid or mucinous
-related to oestrogen excess

Question 5

mutation in endometriod adenocarcinoma?

Answer 5

PTEN mutation

Question 6

risk factors for endometrioid adenocarcinoma?

Answer 6

E2 excess
-nulliparity
-early menarche, late menopause
-metabolic syndrome (PCOS, obesity, diabetes)
-tamoxifen

Question 7

features of non-endometrioid adenocarcinoma?

Answer 7

-high grade, deep
-papillary, serous or clear cell
-unrelated to oestrogen excess - usually in elderly with endometrial atrophy

Question 8

mutations in non-endometrioid adenocarcinoma?

Answer 8

P53 mutations (commonly)

-sometimes PTEN

Question 9

what staging classification for endometrial carcinoma

Answer 9

FIGO staging

Question 10

FIGO stages for endometrial carcinoma?

Answer 10

FIGO
1 = only in uterus
2 = spread to cervix
3= spread to pelvic organs
4 = metastasis to rectum/bladder and distal organs

Question 11

most common distant met for endometrial cancer

Answer 11

lung

Question 12

how does endometrial cancer metastasise

Answer 12

-direct invasion into local structures
-lymphatic system into pelvic LNs
-haematogenous spread (to lungs etc)