Flashcards in Repro 12 Deck (66)
What type of cancer are most carcinomas of the cervix?
What is required for cervical changes to be malignant?
What is CIN?
Cervical intraepithelial neoplasia.
Grade given based on mitotic activity, nuclear pleomorphism/hyperchromasia and nuclear/cytoplasmic ratio
What are the aetiology factors associated with carcinoma of the cervix?
Lifestyle - Number of sexual partners, promiscuity, low social class, smoking
Number of pregnancies
What is the aim of cervical screening?
Detect the pre-invasive lesion and to excise the involved area completely before a tumour can develop
Why is exfoliative cytology adequate for cervical screening?
Cells at surface level always affected no matter what CIN stage
What does cervical screening detect?
Cells with abnormally enlarged nuclei possessing abnormal chromatin
When are women referred for colposcopy?
Abnormal cells and HPV positive
What chemical is used in colposcopy?
Diluted acetic acid
How are abnormal cells commonly existed for biopsy?
How often and at what age are women screened for cervical cancer?
3 years age 25-50
5years age 50-65
What features determine the prognosis of carcinoma of the cervix?
Spread - depth of invasion, size (much more important that differentiation)
Where do cervical carcinomas tend to spread?
Iliac and aortic lymph nodes initially before wider systemic dissemination
Local - ureters, bladder, rectum (extemely distressing with pain and fistula formation)
Who receives the vaccination for HPV?
12-13 year old girls (not effective if already exposed)
What is the most common type of vulval tumour?
Rarer - adenocarcinoma, basal cell and malignant melanoma
What is the cause of vulval tumour?
HPV in pre-menopausal women
In older women, the causative agent is unknown but are probably related to chronic irritation and longstanding dermatoses such as lichen sclerosis and squamous hyperplasia
How might vulval squamous cell carcinoma present?
Scaly red patch
Incidental finding in 30%
Where do vulval carcinomas commonly spread to?
locally and metastasise to the inguinal lymph nodes
Can vuval sqaumous cell carcinoma be cured?
Yes if caught early - vulvectomy
Describe extramammary Paget's disease?
Commonly found in the vulva
24-30% associated with invasive neoplasm
0.2% vulval carcinoma
Average age 63
How does vulval basal cell carcinoma present?
Pearly white/pigmented nodule
Does vulval basal cell carcinoma have a positive prognosis?
Deeply infiltrative if neglected
Does not metastasise
Vulvectomy does not work
What is the common treatment of vulval squamous carcinomas?
Who commonly develops endometrial adenocarcinoma?
Perimenopausal and older women
What causes endometrial adenocarcinoma?
- exogenous oestrogen administration
- hormone-secreting tumour
- late menopause/early menarche (long reproductive lifespan)
What types of cancer may occur in the endometrium?
What does the prognosis of endometrial adenocarcinoma depend on?
Spread in the myometrium
Where does endometrial adenocarcinoma commonly spread to?
Invades myometrium and cervix
Through peritoneal cavity
Regional lymph nodes
When might adjuvant therapy be required to treat endothelial adenocarcinoma?
With involvement of more than half the myometrium depth