Flashcards in Uterine Malingancy Deck (41):
When looking at a pathology report you see that your patient has atypical hyperplasia of the uterus. What specific condition is this a precursor for?
When looking at a pathology report you see that your patient has serous intraepithelial carcinoma of the uterus. What specific condition is this a precursor for?
What condition must you look for in overweight women with PMB?
Which type of endometrial cancer is associated with unopposed oestrogen?
Endometriod and mucinous
Which type of endometrial cancer is not associated with unopposed oestrogen?
Serous and Clear cell
Why does obesity increase the risk of endometrial cancer?
Adipocytes express aromatase with converts ovarian androgens into oestrogens which induce endometrial proliferation
What syndrome predisposes you to colorectal cancer and ovarian cancer?
What mode of inheritence is seen in lynch syndrome?
What gene mutation is seen in serous and clear cell cancer of the endometrium?
What is the difference between simple and atypical endometrial hyperplasia?
Simple hyperplasia is usually generalised where as atypical is usually localised
Which is more dangerous is endometrial hyperplasia; cytological or architechtural abnormaility?
Cytological. These have a greater malignant potential.
What stage is this endometrial cancer; Confined to the uterus with less than 50% of the myometrium being invaded?
What stage is this endometrial cancer; Confined to the uterus with more than 50% of the myometrium being invaded?
What stage is this endometrial cancer; Invasion into the cervical stroma?
What stage is this endometrial cancer; Involvement of pelvic lymph nodes?
What stage is this endometrial cancer; Invasion into the vagina?
What stage is this endometrial cancer; Invasion into the serosa of the uterus?
What stage is this endometrial cancer; Invasion of the bladder?
What stage is this endometrial cancer; Invasion of the rectum?
What stage is this endometrial cancer; brain mets?
What is the peak incidence of endometrial carcinoma?
50 - 60 years
What type of uterine cancer is atypical hyperplasia a precursor for?
What type of cancer is serous intraepithelial carcinoma a precursor for?
How does endometrial carcinoma generally present?
How are endometriod carcinoma generally graded?
By their architechture
Grade 1: 5% or less solid growth
Grade 2: 6 - 50% solid growth
Grade 3: Over 50% solid growth
What is the most common presentation of endometrial stromal sarcoma?
Abnormal uterine bleeding
But can also present with metastases
Which endometrial tumour is a mixture of epithelial and mesenchymal components?
What name is given to a malignant tumour of smooth muscle?
What is the most common type of endometrial carcinoma?
What grade is this endometrial cancer: Well differentiated lesions with 98% glandular formations
What grade is this endometrial cancer: 48% solid areas
What grade is this endometrial cancer: More than 50% solid lesions
What is the best imaging modality for assessing the degree of myometrial invasion in endometrial cancer?
Describe simple uterine hyperplasia
Glands of various sizes, most cystic
No crowding of glands
Small mitotic figures
Describe complex uterine hyperplasia
Crowding of glands
Stratified epithelium with more mitotic figures
Describe atypical uterine hyperplasia
Nuclear atypia is present
Abnormal mitotic figures
Glandular polypoid formations
How is simple uterine hyperplasia treated?
No routine follow up
If patients are symptomatic progesterone agents might help wither orally or via the mierna IUS
What is the risk of progression to endometrial cancer if you have simple uterine hyperplasia?
How is complex uterine hyperplasia treated?
Progesterone therapy with mirena coil
What is the risk of progression to endometrial cancer if you have atypical uterine hyperplasia?
20 - 50%