Session 12 - Cancers of the Reproductive System Flashcards by Matt Quinn

Name six places gynaecological tumours can effect

Vulva
Cervix (neck of uterus)
Endometrium (lining of uterus)
Myometrium (body of uterus)
Ovary
Tumours of gestation (pregnancy)

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What are the most common type of cervical carcinomas?

Squamous carcinoma

Adenocarcinoma

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Give five risk factors for cervical carcinoma

 Sexual intercourse, multiple partners
 Immunosuppression
 Cigarette smoking
 Long term use of the oral contraceptive
pill (OCP)
 Early first pregnancy and increasing risk
with each subsequent pregnancy

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What is one of the viral causative agents of cervical carcinoma?

Human papilloma virus

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Give three macroscopic features of squamous carcinoma cervix

Cervical expansion
Ulceration
Nodules

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Give a main symptom of squamous cervix carcinoma

Post coital, intermenstrual or postmenopausal bleeding

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Give three histological features of a squamous cervix carcinoma

Inflitrating tongues of squamous epithelium
Cytological geatures of malignancy (pleomorphism etc)
Variable differntitation

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Where is the local spread of cervical cancer?

Ureters, rectum
Forms fistula
Lymphatic (paraortic)

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How does cervical screening work?

Exfoliation of epidermal layer of cervix

Cervical cancer is full thickness abnormal dysplasia

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What is cervical cancer graded on?

Mitotic activity
Nuclear pleomorphism, hyper chromasia (dark nucleus)
Nuclear/cytoplasmic ratio

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Outline cerivcal screening, epidemiological

Start age 25th birthday

Every 3 years until 50

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What if someone is HPV positive?

Followed up in usual way with calposcopy

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What if someone is HPV negative?

Returned to screening programme

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What are the two types of endometrial adenocarcinoma?

Type 1 - Unopposed oestrogen tumour

Type 2 - Clear cell and uterine serous papillary

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Why does type 1 endometrial adenocarcinoma happen?

Continued exposure to oestrogen

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Give five main people who develop type 1 endometrial adenocarcinoma?

Obesity !! (responsible for recent increase, due to increasingly unhealthy lifestyle factors)
Nulliparous
Early menarche
Late menopause
HRT

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Why do obese ladies

Androgens produced in adrenal cortex

Aromatised in fat to oestrogen

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What happens in type 2 endometrial adenocarcinoma?

Arises spontaneously in post-menopausal wp,em

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What is the danger of type 2 endometrial carcinoma?

Occurs in women with shruncken uteri, easily becomes malignant

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Give some of the macroscopic features of endometrial adenocarcinoma

Glands present
Malignant epithelium
Invades adnexa (structures closely related to uterus)

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What is the precursor for endometrial cancer?

• simple 
   o cystic glands, abundant     stroma 
• complex 
    o crowded, branched or budded glands 
• complex with atypia 
o cytological features of malignancy of 
varying degrees (EIN)

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Name two different types of endometrial carcinoma, other than 1 and 2

Carcinosarcoma

Endometrial stromal sarcoma

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What is a leiyomyoma?

Smooth muscle cancer (fibroids!)

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What are the sy,ptoms of smooth muscle leiomyoma (fibroids)

Heavy/painful periods
Infertility
Benign

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Give histological features of leiomyoma (3)

``` Interlacing bundles of smooth muscle • rounded ends to nuclei • fibrotic or myxoid stroma ```

Is leiomyoma benign or malignant?

Benign

Is leiomyosarcoma benign or malignant?

Malignant

Where does leiomyosarcoma metastasise?

Lungs

Give four cells from which ovarian neoplasms can arise?

``` o surface epithelium o stroma o sex cord components o germ cells o metastases ```

What is confusing about ovarian neoplasm?

Everything But symptoms are common with IBS, a common bowel condition

What are the most common ovarian cancers?

Serous Mucinous Endometrioid Brenner (transitional cell)

Is ovarian carcinoma benign or malignant?

Can be both

What do mucinous ovarian tumours look like?

- intestinal or (rarely) endocervical mucin secreting epithelium Is often caused by spread from intestines/pancreas

What is endometrioid carcinoma related to?

Endometriosois, often develops secondary in those with past endometriosis who go on HRT

What do ovarian epithelial neoplasms develop as a result of? (talking 'bout secretion from somewhere)

1) Fallopian tube secretions from STIC (serous tubal intraepithelial carcinoma)

Give four causes of ovarian epithelial neoplasms

Smoking HRT Obesity TAYLCUM POWDEER

Give three kinds of sex cord stromal tumours

Granulosa cell tumour • Fibroma/thecoma • Sertoli Leydig cell tumour

What can a granulosa cell tumour cause in young people?

Iso-sexual precocious puberty as a result of oestrogen secretion

What is a key feature of granulosa cell tumour histologically?

Call-Exner Bodies (little white balls in the blue)

What do leydig cell tumours cause in mails?

Androgen production and virilisation

What do you see histologically in leydig cell tumours?

Crystals of Reinke (

What is a mature cystic teratoma?

An ovarian germ cell tumour

What is odd and disgusting about mature cystic teratoma

``` Skin Hair Teeth Bone ALL INSIDE THE OVARY ```

What is a good marker for an endodermal sinus tumour?

AFP BHCG

Give three types of vulval tumour (IMPORTANT(

Squamous carcinoma Adenocarcinoma Basal cell carcinoma

Where is vulval carcinoma found?

Mainly labia

Give three macroscopic features of vulval carcinoma

Keratotic, watey or ulcerated

How is vulval carcinoma caused?

HPV

Give four features of a vulval rash which is indicatve of vulvular carcinoma

Scaly red patch • sore • itchy • white

What is the histology of a vulval carcinoma?

Abnormal maturation Mitotic activity above basal layer Basloid cells above basal layer

What is vuval basal cell carcinoma?

Pearly white or pigmented nodule Ulcerated Labium majora effected

Describe key features of gestational tumours

What is a hydatiform mole? (IMPORTANT)

An abnormal form of pregancy in which a non-viable fertilised egg implants in uterus.

When does hydatiform mole form?

Dispermic (complete 46 XX or 46 XY | One egg nuclei and two sperm (69 XXY)

What is the danger of a hydatidiform mole?

10% risk of malignancy

What occurs in a placental site trophoblastic tumour?

Intermediate trophoblastic cells colonis the blood vessels, widening them. If that does not happen eclampsia. hese can cause tumooouuursss.

What are the most common types of vulval carcinoma?

Squamous carcinoma

What is the major causative factor of vulval cancer in pre-menopausal women?

HPV

What is the focal point for the development of vulval cancer?

VIN (vulval intraepithelial neoplasia) from HPV invasion into intraepithelial cells

What is an early cure for precursor to vulval cancer?

VIN excision

What are the causative agents of vulval carcinoma in older women?

Chronic irritation and longstanding dermatoses such as lichen sclerosus and squamous hyperplasia

Session 12 - Cancers of the Reproductive System Flashcards

(61 cards)