Studied by 12 people
includes uterus, cervix, and ovaries
how is cervical cancer diagnosed?
through PAP smear before tumor is large enough to see sonography
what age of women are affected by cervical cancer?
normally women who are menstruating
what are the symptoms of cervical cancer?
vaginal discharge or abnormal bleeding
what is hydrosalpinx?
fluid in the fallopian tubes
what is hematosalpinx?
blood in the fallopian tube
what is pyosalpinx?
pus in the fallopian tube
what is the most common risk factor of endometrial carcinoma?
estrogen
what are the risk factors of endometrial cancer?
ESTROGEN (overproduction or unopposed)
obesity
diabetes
nulliparity
late menopause
tamoxifen
what are other risk factors of endometrial carcinoma?
endometrial hyperplasia
breast, ovarian, endometrial, or colorecal cancer personal or familial history
granulosa cell tumors
PCOS
lynch syndrome
history of pelvic radiation
what cancer is post - coital bleeding a symptom of?
cervical cancer
what percentage of cancers are caused by HPV?
>99% of cervical
can also cause vaginal, vulvar, anal, penile, and oral cancers
what uterine tumor is very similar to a phyllodes tumor in the breast?
uterine adenosarcoma
what does type 1 endometrial carcinoma include?
grades 1 & 2
usually not aggressive, slow spread
associated with unopposed estrogen, endometrial hyperplasia
better differentiation
more responsive to therapy
better prognosis
what does type 2 endometrial carcinoma include?
more aggressive, grows faster, spreads earlier, less responsive to therapy
poorly differentiated
not associated with endo hyperplasia - doesn’t begin as endometrial hyperplasia
papillary serous carcinoma, clear cell carcinoma, carcinosarcoma, undifferentiated carcinoma, grade 3 endometrial carcinoma
how do we grade endometrial carcinomas?
based on amount of “endometrial - looking” tissue present
what is grade 1 endometrial cancer?
> or = 95% glandular tissue present
what is grade 2 endometrial cancer?
50-94% glandular tissue present
what is grade 3 endometrial cancer?
<50% glandular tissue
poorly differentiated
more aggressive, less responsive to therapy, metastasize earlier
what is stage 1A endometrial carcinoma?
no myometrial invasion or < ½ myometrial thickness
what is stage 1B endometrial carcinoma?
myometrial invasion > or = ½ myometrial thickness but not perforating uterine wall
what is stage 2 endometrial carcinoma?
tumor invades cervix but does not extend beyond uterus
what is stage 3 endometrial carcinoma?
local and/or regional spread of tumor beyond the uterus
what is stage 3A endometrial carcinoma?
tumor perforates uterine wall (invades uterine serosa) or invades adnexa
what is stage 3B endometrial carcinoma?
tumor invades vagina and/or parametrium
what is stage 3C endometrial carcinoma?
tumor has spread to lymph nodes
two sub types:
1: pelvic lymph node involvement
2: para-aortic lymph node involvement (beyond aorta)
what is stage 4 endometrial carcinoma?
tumor invades bladder and/or bowel mucosa; and/or distant mets.
what is stage 4A endometrial carcinoma?
tumor invasion of bladder or rectal mucosa
what is stage 4B endometrial carcinoma?
distant metastases: inguinal lymph nodes, liver, peritoneum, lung, bone, brain, cutaneous, etc
what does tamoxifen therapy increase the risk for?
endometrial carcinoma
uterine adenosarcoma
carcinosarcoma
what pathology is this?
endometrial stromal sarcoma
what is this pathology?
endometrial carcinoma
what pathology is this?
carcinosarcoma
what is CA 125?
primarily used for ovarian cancer
can also be elevated in other pelvic conditions like endometriosis - super sensitive (lots of false positives)
what is CEA?
carcinoembryonic antigen
considered a broad-spectrum marker, elevated in colon, stomach, breast, and other cancers
also in non-cancerous conditions like inflammation
when should patients be screened for ovarian cancer?
if they are at an increased risk who have multiple elevated tumor markers
what are the risk factors of ovarian cancer?
age - over 50
uninterrupted ovulation (no pregnancy or delayed pregnancy)
infertility
personal history of cancer or endometriosis
familial history of ovarian, uterine, breast, colon, or rectal cancer
genetics (presence of BRCA1, BRCA 2, HER2, etc)
lynch syndrome
PTEN hamartoma tumor syndrome
peutz-leghers syndrome
MUTYH-associated polyposis
living in an industrialized nation
HRT
obesity
smoking
which ovarian cancer has doppler flow septations?
serous cystadenocarcinoma
what percentage of ovarian cancer patients are diagnosed at stage 1?
15%
