Gynae Cancer Flashcards Preview

Toni's Obs and Gynae > Gynae Cancer > Flashcards

Flashcards in Gynae Cancer Deck (14):
1

Endometrial carcinoma risk factors

Nulliparity
Early menarche + late menopause
Obesity

2

Presentation of ovarian cancer

Pelvic pain
Anorexia, nausea + vomiting, change in bowel habit, weightloss, abnormal PV bleed, urinary sx, malaise, DVT, virilisation, precocious puberty
Abdo/pelvic mass, ascites, pleural effusion, cervical lymphadenopathy, hepatomegaly

3

Types of epithelial ovarian cancer

Serous: 50% all ovarian Ca, fluid filled cysts, psamomma bodies
Mucinous:
Endometroid
Clear cell
Brenner/urothelial like

4

Serous ovarian cancer

Serous cystadenoma: benign
Unilocular straw coloured fluid filled cysts, 20% bilat
Serous cystadenocarcinoma:
Mixed solid areas + unilocular cysts, psammoma bodies (concentric, laminated, calcified, concretions), bilat in 30-50%

5

Sex cord/stromal ovarian tumours

Granulosa cell
Thecoma/fibroma
Sertoli/Leydig

6

Germ cell tumours

Dysgerminomas
Endodermal sinus
Yolk sac tumours
Choriocarcinoma
Teratoma (dermoidcyst)

7

Risk factors for endometrial cancer

Related to unopposed oestrogen exposure
Incr age, obesity, PCOS,
Nulliparity, early menarche, late menopause
Oestrogen only HRT, tamoxifen,
Oestrogen secreting tumour
Hx: breast or colon Ca
Fhx: breast, colon, ovarian Ca

8

Protective factors against endometrial cancer

COCP
progesterones
pregnancy

9

Presentation of endometrial cancer

Post menopausal bleeding : endometrial cancer until proven otherwise
Irreg/intermenstrual bleeding or menorrhagia in pre menopausal

10

Staging of endometrial tumours

1: confined to uterus
2: confined to uterus and cervix
3: invade through cervix/ uterus
4: bladder/ bowel involvement or distant mets

11

Side effects of radiotherapy

Acute: skin irradiation, dysuria, diarrhoea,
Chronic: urinary frequency, vaginal dryness, dyspareunia

12

Breast cancer in pregnancy

Tamoxifen: not safe in pregnancy or breastfeeding- teratogenic
Radiotherapy: contraindicated unless life saving
Chemo: ok 2nd and 3rd trimesters, birth 2-3 wks after last session
Bone scans / CT: insufficient benefit for radiation risk

13

RMI

Risk of malignancy index
CA125 x cyst characteristics on USS x menopausal status
259: 75% cancer

14

Conservative management of ovarian cyst

4 monthly USS