Malignant Disease of the uterus and Cervix

What is the most commonly encountered gynecologic malignancy in developed nations?

Endometrial carcinoma

In which demographic is the highest incidence of endometrial carcinoma found?

Postmenopausal women (60+ years old)

What is a common early symptom of endometrial carcinoma?

Postmenopausal bleeding

What is the relationship between estrogen and endometrial cancer?

There is a strong relationship between increased estrogen and the development of endometrial cancer.

List some risk factors associated with endometrial carcinoma.

Obesity, anovulatory cycles, estrogen replacement therapy, atypical hyperplasia, oral contraceptive use, Tamoxifen therapy, strong family history of uterine cancer.

How does endometrial carcinoma typically spread?

It invades and spreads through the myometrium to the cervix and into the adnexa.

What are common clinical signs of endometrial carcinoma?

Postmenopausal vaginal bleeding, hypermenorrhea, intermenstrual flow, and pain from uterine distension.

What distinguishes Stage I or II endometrial carcinoma from Stage III or IV?

Stage I or II is confined to the uterus, while Stage III or IV extends beyond the uterus and may involve bladder or rectum.

What is the preferred imaging method for endometrial carcinoma?

Endovaginal approach

What are some sonographic findings in endometrial carcinoma?

Alteration in size, shape, and texture of uterine parenchyma, increased uterine size, inhomogeneity and thickening of endometrial echoes, fluid in the endometrial cavity.

What is the prognosis for endometrial carcinoma dependent on?

Patient age, stage of cancer, level of metastasis, and intervention level (early vs late).

What is Uterine Leiomyosarcoma?

An extremely rare and aggressive malignancy arising from the myometrium, usually with a poor prognosis.

What are common clinical signs of Uterine Leiomyosarcoma?

Abnormal vaginal bleeding, pelvic/abdominal pain, and a palpable mass in the pelvis.

What is the typical sonographic appearance of Leiomyosarcoma?

A single large hypoechoic solid uterine mass that may be indistinguishable from fibroids.

What is Fallopian Tube Carcinoma and its risk factors?

A rare and aggressive tumor with increased risk associated with BRCA-1 and BRCA-2 gene presence.

What are common clinical presentations of Fallopian Tube Carcinoma?

Vaginal bleeding/spotting, pelvic pain, and vaginal discharge.

How is Cervical Carcinoma diagnosed?

Via Pap smear, colposcopy, and cone biopsy.

What are the main risk factors for Cervical Carcinoma?

HPV infection, early sexual activity, multiple sexual partners, smoking, and oral contraceptive use.

What are common sonographic findings in Cervical Carcinoma?

Normal appearance early in disease, enlarged or bulky cervix, hydronephrosis, and involvement of other pelvic organs.

What is Gestational Trophoblastic Disease (GTD)?

A spectrum of pathologic conditions resulting from abnormal proliferation of trophoblastic tissue.

What are the types of Gestational Trophoblastic Disease?

Invasive mole, choriocarcinoma, placental site trophoblastic tumor (PSTT), and epithelioid tumor.

What are common clinical findings in GTD?

Enlarged uterus, markedly elevated hCG levels, vaginal bleeding, hyperemesis gravidarum, and absence of fetal heart tones.

What is a Complete Hydatidiform Mole?

The most common form of trophoblastic disease, characterized by the presence of chorionic villi and trophoblastic proliferation.

What is Choriocarcinoma?

A rare type of persistent trophoblastic neoplasia with aggressive spread and absence of chorionic villi.

What is the Placental Site Trophoblastic Tumor (PSTT)?

A rare but fatal form of GTN that occurs post-delivery and infiltrates from the decidua to myometrium.