Uterine Cancer

Question 1

What are the germline mutations in Lynch II syndrome?

Answer 1

MLH1, MSH2, MSH6, PMS2, EPCAM

Question 2

What percentage of endometrial cancers are related to Lynch syndrome?

Answer 2

6%

Question 3

What are the findings of Cowden disease?

Answer 3

Increased risk of breast cancer, thyroid cancer, endometrial cancer
PTEN overexpression

Question 4

What is the management for uterine bleeding on tamoxifen?

Answer 4

Endometrial biopsy regardless of endometrial thickness

Question 5

What is the risk of endometrial cancer in tamoxifen users?

Answer 5

2x risk
Decreases with discontinuation
Increased risk of uterine sarcoma

Question 6

Stage 1 endometrial cancer

Answer 6

Confined to uterus
1A - <50% of myometrium
1B - > 50% of myometrium

Question 7

Stage 2 endometrial cancer

Answer 7

Involving stroma of cervix

Question 8

Stage 3 endometrial cancer

Answer 8

Involving other gyn organs/serosa
3A - serosa or adnexa
3B - vaginal or parametrial involvement
3C - lymph nodes

Question 9

Stage 4 endometrial cancer

Answer 9

4A - bladder or bowel mucosa

4B - distant mets (including intraperitoneal disease)

Question 10

What is the adjuvant treatment for uterine smooth muscle tumor of uncertain malignant potential?

Answer 10

Nothing

Question 11

Mutations associated with endometrioid type endometrial cancer

Answer 11

PTEN
Beta-catenin
KRAS
DNA mismatch repair proteins

Question 12

Mutations associated with uterine papillary serous cancer

Answer 12

TP53
HER2/neu
Bcl2

Question 13

Colon cancer screening for HNPCC

Answer 13

Colonoscopy at age 20, every 2 years, then yearly after age 35