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(4) Reproductive System - Sessions > (12.1+2) Gynaecological Tumours > Flashcards

(12.1+2) Gynaecological Tumours Flashcards

1
Q

Suggest some causes of Cervical cancer.

A
  • HPV (types 16, 18)
  • Multiple partners
  • Smoking
  • Early/multiple pregnancies
  • OCP
  • Low socioeconomic class
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2
Q

What is the precursor of Cervical Adenocarcinomas?

A

Cervical glandular intraepithelial neoplasia (CGIN)

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3
Q

What is the precursor of Cervical Squamous Cell Carcinomas?

A

Cervical intraepithelial neoplasia (CIN)

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4
Q

What is the most common type of Cervical cancer?

A

Squamous cell carcinoma (much more common than adenocarcinoma)

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5
Q

Where do squamous cell cancers of the cervix usually occur?

A

Transformation zone between cervix and vagina (at the external os during puberty, moves up cervical canal as age)

  • Upper: simple columnar
  • Lower: stratified squamous non-keratinised
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6
Q

Where do cervical cancer commonly spread? By what route?

A
  • Lymphatics to Iliac nodes, advanced to Para-aortic nodes

- Directly to bladder, ureters, rectum

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7
Q

Suggest some common symptoms of cervical cancer.

A
  • Dysparaneuria
  • Discharge
  • Bleeding - post coital, intermenstrual, post menopausal
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8
Q

Describe the underlying pathology of Squamous cell cervical cancer

A
  • Invasion of squamous epithelium
  • Cervical expansion
  • Ulcers and/or nodules
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9
Q

What are the four types of Ovarian epithelial tumours? Which is the most common?

A
  • Serous (most common)
  • Mucinous
  • Endometroid
  • Brenner (transitional)
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10
Q

What are some of the risk factors of Ovarian cancer?

A
  • HRT (over proliferation of endometriosis)
  • Super-ovulation following IVF
  • Smoking
  • Obesity
  • Prior cyst
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11
Q

What can the symptoms of an Ovarian tumour commonly be confused with?

A

Irritable bowel syndrome (IBS)/Pre-menstrual syndrome

  • Heavy bleeding
  • Pelvic/abdominal pain
  • Nausea/difficult eating
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12
Q

How do ovarian cancers commonly spread? What can this cause?

A

Transcoelmically (through the peritoneum):

  • Ascites
  • Obstruction
  • Perforation (risk of Peritonitis)
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13
Q

Explain how you would determine whether serous ovarian tumours are benign, borderline or malignant.

A
  • Benign: no mitosis
  • Borderline: mitotic -> proliferation
  • Malignant: invasive -> through basement membrane, stroma, capsule and eventually peritoneum
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14
Q

Describe an endometrioid ovarian tumour. What is the risk factor and its prognosis.

A
  • Tumours of the ovary resemble the endometrial lining to the uterus
  • HRT -> rapid proliferation -> endometriosis (normal internal uterine tissue grows on outside)
  • Mostly malignant
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15
Q

What may be the complications of a Granulosa cell ovarian tumour.

A
  • Oestrogen producing -> Endometrial tumours / iso-sexual precocious puberty
  • Spread intra-abdominally
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16
Q

What are the risk factors of vulval cancers in the young different from the middle-aged/elderly?

A
  • Pre-menopausal: HPV (types 16, 18) same as cervical cancer

- Post-menopausal: Lichen sclerosis / Squamous hyperplasia / Paget’s disease of vulva

17
Q

What is the pre-invasive state of vulval squamous cell carcinoma known as?

A

Vulval intraepithelial neoplasia (VIN)

18
Q

How does vulval intraepithelial neoplasia present?

A
  • Sore & red
  • Scaly
  • Itchy
  • Spots of white
19
Q

Why wouldn’t you do a vulvectomy in basal cell carcinoma of the vulva?

A

It grows slowly, rarely metastasis

20
Q

What is the most common type of Vulval cancer? What does it look like?

A
  • Squamous cell carcinoma

- Warty & ulcerated

21
Q

What are the four main types of Vulval cancer?

A
  • Squamous cell
  • Basal cell
  • Adenocarcinoma
  • Melanoma
22
Q

What does basal cell carcinoma of the vulva commonly look like?

A

Pearly/translucent appearance (most basal cell carcinomas do)

23
Q

Describe how a squamous cell carcinoma of the vulva can result in unilateral gangrene of parts of the lower limb.

A

Erosion into femoral artery -> ischaemia of parts of the leg

24
Q

What are the main types of cancer of endometrium?

A
  • Adenocarcinoma
  • Carcinosarcoma
  • Stromal sarcoma
25
Q

Suggest two ways Endometrial Adenocarcinomas spread.

A
  • Directly to fallopian tubes, cervix and myometrium

- Lymphatics

26
Q

Describe the Endometrial carcinosarcomas. How’s its prognosis?

A
  • Mixed type tumour of Epithelial (carcinoma) + connective (sarcoma) tissues
  • Poor prognosis
27
Q

What is the difference between homologous and heterologous endometrial carsinosarcomas.

A
  • Homologous: sarcoma sections made up of tissues that are identifiable as from parts of the uterus
  • Heterologous: sarcoma sections made up of extrauterine tissues e.g. cartilages, muscles, bones
28
Q

In which groups of woman do Endometrial carcinosarcomas commonly occur? Which other cancer are these women at risk of?

A
  • Post-menopausal who takes HRT

- Same risk factors of adenocarcinoma

29
Q

How do endometrial stromal sarcomas spread?

A

Bloodstreams -> highly vascular organs e.g. lungs, liver, brain

30
Q

Describe how Leisarcomyomas occur.

A

Arise de novo as a single mass, not from Leimyomas

31
Q

What is the other name for a mature teratoma?

A

Dermoid cyst

32
Q

What is a hydratidiform mole?

A

Where a non-viable pregnancy implants, but won’t be alive at term

(4) Reproductive System - Sessions (16 decks)

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