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DM 2 - Gynecology > Uterine Pathologu > Flashcards

Uterine Pathologu Flashcards

(49 cards)

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1
Q

What imaging modality can assist with pre surgical staging?

Uterine cancer

A

MRI

  • myometrial invasion
  • cervical extension
  • parametrial involvement
  • lymph nodes
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2
Q

Stage 1A endometrial

A

Confinded to the corpus

<50% myometrium

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3
Q

Stage 1B

A

Limited to corpus

> /= 50%

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4
Q

Stage 2

A

Tumor invades cervical stroma but not beyond uterus

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5
Q

Stage 3A

A

Tumor Invades serosa +/- adnexa

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6
Q

Stage 3B

A

Vaginal involvement +/- parametrium

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7
Q

Stage 3C1

A

Positive pelvic nodes

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8
Q

Stage 3C2

A

Positive paraaortic nodes +/- pelvic

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9
Q

Stage 4A

A

Bladder +/- bowel mucosa

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10
Q

Stage 4B

A

Distand metastasis

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11
Q

Grade 1 disease

A

<5% nonsquamous or nonmorular solid growth pattern

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12
Q

Grade 2

A

6-50% nonsquamous or nonmorular solid growth

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13
Q

Grade 3

A

> 50% nonsquamous or nonmorular

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14
Q

What are the characteristics if high risk disease?(5)

A
  • grade 3 tumor
  • lymphovascular space invasion
  • non endometriod histology( serous, clear cell, undifferentiated etc)
  • cervical stromal involvement
  • p53 molecular type
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15
Q

What imaging modalities are used to assess for recurrent disease?(2)

A
  • CT
  • FDG-PET/CT
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16
Q

What is the most common site of recurrence?

A

Vaginal cuff

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17
Q

Incidence of endometrial cancer

A

28 : 100,000

9000 new cases per year (UK)

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18
Q

Peak age of diagnosis

A

60-79 yo

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19
Q

What percentage is due to lifestyle and other known risk factors?

A

34%

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20
Q

Since the 1990s, mortality from endometrial cancer has increased or decreased?

Study These Flashcards
A

Increased by 25%

21
Q

What surgery would you perform for a grade 1 stage 1a endometriod adenocarcinoma

Study These Flashcards
A

Total laparoscopic hysterectomy and bilateral salpingo-oophrectomy

22
Q

Increasing incidence is due to what factors ? (3)

Study These Flashcards
A
  • obesity
  • nulliparity
  • aging population
23
Q

What is the effect of parity on the incidence of endometrial cancer?

Study These Flashcards
A

Nulliparity- increase (35-40% of cases are nulliparous)

Para 1- reduces risk by 30%

Para 2+ - additional 25% per pregnancy

24
Q

Effect of estrogen HRT on endometrial CA?

Study These Flashcards
A

2.3 times higher than non users

25
PCOS and endometrial ca
2.8 times higher than normal females
26
How does type 2 diabetes impact endometrial ca
40-80% increased risk (Link possibly due to obesity and not directly to DM)
27
Risk of endometrial cancer with LYnch syndrome
40-60%
28
What ate protective factors against endometrial cancer (4)
- cigarette smoking (20-40%) - COCP (25%) - coffee intake (21%) - exercise (15-25%)
29
Overall 5 year survival of endometrial cancer
80%
30
5 year survival stage 1 EC
85-90%
31
5 year survival stage 2 EC
75%
32
5 year survival stage 3 EC
45%
33
5 year survival stage 4 EC
<30%
34
What is the risk association if endometrial cancer and Cowden syndrome
30% life time risk
35
Types of uterine sarcomas (5)
1- leiomyosarcoma 2- endometrial stromal 3- undifferentiated uterine sarcoma 4- carcinosarcoma 5- mesenchymal
36
What is the most common uterine sarcoma
Leiomyosarcoma (60%)
37
What are the highest combination factors for developing endometrial cancer in patients with PMB
- PMB - obesity - diabetes Total risk 29%
38
What is the overall risk of endometrial ca with PMB
10%
39
What is the risk of endometrial ca with PMB @ <50yrs old
1%
40
What percentage of patients with PMB have endometrial or cervical polyps
25% Asymptomatic polyps 11.8%
41
Risk of malignancy withing an endometrial polyp
3%
42
Risk factors for malignant change of an endometrial polyp
- size >10mm - menopause - aub
43
Prevalence of atypia within a polyp
0.8%
44
What is the risk of malignant progression of hyperplasia without atypia
<5% over 20 years
45
What is the surveillance of EH without atypia on hormonal mx
6mnthly endometrial biopsy until 2 negative samples
46
What is the risk of malignant progression with EH with atypia
25-30% in 10 years
47
Risk.of endometrial CA if endometrial stripe 4mm or less
<1%
48
What percentage of endometrial ca is genetic
2-5%
49
What percentage of patients with a granulosa tumor will have endometrial cancer
10-15% 1:3 have hyperplasia

DM 2 - Gynecology (22 decks)

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