what type of cells is the exocervix made up of?
squamous
what type of cells is the endocervix made up of?
columnar mucin-secreting
what is the t-zone? and what is its significance?
area of transition between the endocervix and the exocervix
immature metaplastic squamous cells are susceptible to mutagenic oncogenic stimuli
•easily infected by human papilloma virus (HPV)
•most cervical precancerous changes occur in the vicinity of the transformation zone
what is cervcal cancer caused by?
HPV
How does one prevent HPV and thus prevent cervical cancer?
- safe sex practices, i.e. condom use
- routine cytologicscreening using the Papanicolaoutest (“Pap smear”)
- HPV vaccinaton
What causes endometrial hyplerplasia and thus endometrial carcinoma?
unopposed estrogen
what is unopposed estrogen assoc. with?
- Failure to ovulate
- Perimnopausal
- Polycystic ovarian disorder
- Obesity
- Hormone replacement therapy for menopausal symptoms
- Functional tumours
What is the most common malignancy of the female genital tract post-menopausall
Endometrial adenocarcinoma
What is endometriosis?
Presence of benign endometrial tissueoutside of normal location
Talk about some theories of pathogenesis of endometriosis
- Retrograde menstruation through fallopian tube, with implantation of endometrial tissue
- Metaplastic transformation in the peritoneum and connective tissue
- Vascular or lymphatic dissemination of endometrial tissue -“benign metastases”
- Genetic predisposition
What is the most common tumour of the female genital tract?
Leiomyoma/fibroid benign neoplasm •composed of smooth muscle cells •respond to hormonal stimuli •often multiple, round, vary in size, location
What is the clinical presentation of leiomyoma/fibroids?
asymptomatic OR present with: •menorrhagia •pelvic pain •dysmenorrhea •infertility
What are the possible outcomes of ectopic pregnancy?
- May degenerate and not cause any symptoms
- Detected early may be treated with chemotherapy
- More often surgical excision of the affected segment
What are possibel sequalae of PID?
Sequelae: •Pyosalpinx •Hydrosalpinx •Strictures or adhesions •Tubo-ovarian abscess •Chronic salpingitis •Infertility, •Ectopic pregnancy
Why does ovarian carcinoma have such a bad outcome?
Worse outcome because:
•Often asymptomatic, or mild non-specific symptoms until too late
•No specific screening test
•Therefore more likely to present at an advanced stage
What is the clinical presentation of ovarian carcinoma?
- Ovarian mass in a post-menopausal woman
* Frequently bilateral, usually mixed cystic and solid, often papillary growth; potential to metastasize
What is the most common malignancy in men?
Prostate Adenocarcinoma
What’s the deal with PSA?
Prostate specific antigen
•PSA produced by prostatic glands, normally secreted into prostatic fluid
•Elevated blood level of PSA in prostate carcinoma
•PSA elevation is not specific for cancer.Benign conditions (hyperplasia or prostatitis) can elevate blood PSA
•PSA monitoring post-treatment to screen for recurrence
