Week 4- DMS 212 Malignant Diseases

adenocarninoma

malignant tumor arising from any glandular organ

androstenedione

naturally occurring steroid hormone used to increase serum testosterone levels

antiestrogen

Any substance that blocks or modifies the action of estrogen

brachytherapy

procedure that involves placing radioactive material inside the body to treat cancer

cervical stenosis

narrowing or obstruction of the cervical canal

choriocarcinoma

metastatic trophoblastic neoplasia that can result from any preg but mostly occurs with molar preg

endometrial carcinoma

malignant layer of cells form in the endo

endometrial carcinoma presents as

abnormal thickening of endo, irregular bleeding

endometrial hyperplasia

results from estrogen stimulation to the endometrium without progestin and frequent cause of abnormal uterine bleeding in postmenopausal women

endometrial polyp

pedunculated or sessile mass growing from endo

sessile

connect w/o stalk

endometroid

tumor that resembles endo tissue

epithelioid trophoblastic tumor

Variant of placental site trophoblastic tumor

fallopian tube carcinoma

malignancy of fallopian tube

fallopian tube carcinoma is linked to

BRC-A-1 and BRC-A-2

what is the most common type of fallopian tube carcinoma

adenocarcinoma

gadolinium

contrast used in MRI

gestational trophoblastic neoplasia (GTN)

group of rare diseases; when abnormal trophoblast cells overtake and complicate preg and propagate through the uterus

where does GTN arise from

placental chorionic villi after conception

Persistent Trophoblastic Neoplasia (PTN)

malignant from of GTN

granulosa cell tumor

estrogen releasing tumor that arises from granulosa cells

granulosa cell tumor characteristics

large complex ovarian masses

human chorionic gonadotropin (hCG)

hormone produced by chorionic cells in the fetal part of placenta during pregnancy

hCG can cause

morning sickness / vomiting

when would you expect to find elevated hCG levels

GTN

multiple preg

fertility treatment

human papillomavirus (HPV)

sexually transmitted disease that causes lesions on the mucous mems

what is the most common STD

HPV

_________ is a causative factor in cervical carcinoma

HPV

hydrops tubae profluens

Watery discharge sometimes present with fallopian tube carcinoma

invasive mole

type of GTN deriving from a hydatidiform mole that invades the myometrium

leiomyoma

benign tumors composed of smooth muscle and fibrous CT

leiomyosarcoma

malignant uterine tumor composed of smooth muscle and fibrous CT

leiomyosarcoma appears the same as a _______________ on US

leiomyoma

metastases

Transfer of a cancerous lesion from one area to another

methotrexate

drug that inhibits cellular repro

methotrexate can be used to treat

psoriasis

various malignant neoplastic diseases

immunosuppressive agent

ectopic preg

pelvic inflammatory disease

infection of the uterus, fallopian tubes and adjacent pelvic structures

Papanicolaou (Pap) smear

cytology study used to detect cancer

-most often used to prevent/diagnose cervical cancer

pelvic inflammatory disease is a pelvic infection usually caused by...

an ascending infection of vagina/cervix

Persistant Trophoblastic Neoplasia (PTN)

malignant form of GTN most often from molar preg

placental site trophoblastic tumor (PSTT)

type of PTN that usually occurs several years after a normal pregnancy

PCOS involves symptoms such as...

infrequent or irregular menses

excess male hormones

oligo or anovulation

enlarged ovaries w/ numerous peripheral sub centimeter follicles

polypoid

Growth similar to a polyp

radiation therapy

cancer treatment that uses high doses of radiation to kill and shrink cancer cells

raloxifene

drug that blocks hormone receptors to reduce breast cancer risk

resisitive index

used to assess vasc flow resistance

why is resistive index important when differentiating benign lesions from malignant lesions

malignant lesions are usually low RI

sonohysterography

injection of saline into uterus under US guidance to identify endo pathology (polyps)

squamous cell carcinoma

slow-growing malignant tumor composed of squamous epithelium

what is the most common type of cervical cancer

squamous cell carcinoma

tamoxifen

nonsteroidal antiestrogen compound used for cancer treatment of breast cancer

tamoxifen can cause

endometrial hyperplasia

teratogenic

Causing congenital anomalies or birth defects

what is the most common gynecologic cancer on the US

endometrial carcinoma

what are some rick factors for endometrial carcinoma

obesity

nulliparity

late menopause

adenomatous polyps

family hx

unopposed estrogen

S/S of endometrial carcinoma

uterine bleeding, pain

sonographic findings of endometrial carcinoma

heterogenous endo

irregular or poorly defined endo

cystic changes

hydrometra or hematometra

enlarged ut

lobular contour ur

endo thickening

endometrial carcinoma usually occurs in the __________decade of life

6 to 7th

treatment of endometrial carcinoma

total hysterectomy

lymphadenectomy

radiation and chemo

total hysterectomy is the removal of

uterus

ovaries

tubes

diagnostic features of endometrial carcinoma on TV imaging

endo thickness, texture, vascularity

Stage I or II endometrial carcinoma

confined to the ut

stage III or IV endometrial carcinoma

Extends beyond the uterus

Bladder/rectum infiltration

Adjacent mass

Ureteral obstruction

doppler of endometrial carcinoma

increased flow inside lesion

low RI

technique for imaging endometrial cancer

endo thickness measurement

power doppler

uterine and cervix echogenicity

ascites

diagnosis criteria for endometrial cancer

sub endometrial halo irregularity

fluid

vessel architecture/branching pattern

in a pt with suspected endometrial cancer what might be some other organs to image

liver

abdominal viscera

kidneys

para aortic/caval adenopathy

MRI or CT may be better for imaging what types of endometrial carcinoma

lymphadenopathy

metastatic disease (stage III and IV)

endometrial cancer differential diagnosis

endo hyperplasia

endo polyps

leiomyoma

cervical cancer

_______________________________ are extremely rare

leiomyosarcomas

risk factors for leiomyosarcomas

nulliparity, 40yrs and older, obesity, pelvic radiation, tamoxifen

S/S of leiomyosarcomas

vaginal bleeding

abdominal pain

rapid increase in mass size

sonographic findings of leiomyosarcomas

rapidly growing heterogenous mass

single

large

acoustic enhancement

anechoic or complex areas due tumor liquefaction

increase intra tumoral flow

leiomyosarcomas are normally located where inside the uterus

intramural

appearance of leiomyosarcomas

fleshy

hemorrhagic/necrotic

infiltrative borders

treatment of leiomyosarcomas

total hysterectomy

peritoneal washing

nodule sampling

radiotherapy

sonographic technique for imaging leiomyosarcomas

uterine mass echotexture

adnexal masses

free fluid

para aortic/caval area for adenopathy

other imaging modalities that may be helpful when identifying leiomyosarcomas may include

MRI

CT

FDG-PET

differential diagnoses for leiomyosarcomas

other uterine sarcomas

endo adenocarcinoma

adenomyomas

GI cancer

bladder cancer

____________________ is known to be rare, aggressive, and to occur in the 6th decade of life

fallopian tube carcinoma

risk factors of fallopian tube carcinoma

over 40, BRCA chromosomal mutations, infertility, nulliparity, low parity, PID, family hx of ovarian cancer

S/S of fallopian tube carcinoma

elevated CA-125

vaginal bleeding/spotting

abdominal pain

abdominal or pelvic mass

ascites

hydrops tubae profuens

postmenopausal bleeding or spotting w/ neg PAP smear

sonographic findings of fallopian tube carcinoma

cystic mass w/ mural nodules and hydrosalpinx

ill-defined or sausage shaped mass

multilobular mass

pelvic ascites

neovascularization

tubal wall irregularities

clinical diagnoses of fallopian tube carcinoma

asymptomatic or abdominal pain

increased abdominal girth

vaginal bleeding

palp mass

hydrops tubae profluens

hydrops tubae profluens

profuse watery vaginal discharge

treatment of fallopian tube carcinoma

hysterectomy

peritoneal biopsy

lymph node sampling

radiation/chemo

hydrosalpinx

water in the fallopian tube

in a pt with suspected fallopian tube carcinoma what might be some other organs to image

kidneys

liver

abdominal viscera

differential diagnoses of fallopian tube carcinoma

ovarian carcinoma

myoma

PID

other adnexal masses

__________________ is becoming less prevalent and occurs in the 3rd to 4th decade of life

carcinoma of the cervix

risk factors for carcinoma of the cervix

HPV, early sexual activity, multiple partners, smoking, oral contraceptives, weak immune system, DES exposure

S/S of carcinoma of the cervix

asymptomatic

postcoital bleeding

superficial mass on cervix

watery vaginal discharge

back pain

bladder irritability

ureteral obstruction

uremia

sonographic findings of carcinoma of the cervix

normal appearance in stage I and II

hematometra

multiple cystic areas

bulky cervix

irregular cervical borders

hydronephrosis

liver metastasis

para-aortic nodules

treatment of carcinoma of the cervix

cone biopsy

radiotherapy

surgery

radiotherapy/chemo

the American cancer society recommends ____________________ to prevent HPV and further prevent carcinoma of the cervix

Gardasil

Stage I and II carcinoma of the cervix

normal size/echogenicity

hematometra due to cervical stenosis

Stage III and IV carcinoma of the cervix

bulky cervix

bladder invasion

hydro

liver metastasis

para aortic/caval nodes

what are some other types of US used to image carcinoma of the cervix

translabial

transperineal

TV

differential diagnoses of carcinoma of the cervix

lower uterine segment leiomyoma

benign endo polyp

endo cancer

types of GTN's

benign hydatidiform mole

invasive mole

choriocarcinoma

placental site trophoblastic tumor (PSTT)