Uterine Malignancy

Question 1

what are the 3 types of the endometrial hyperplasia

Answer 1

simple
complex
atypical

Question 2

what form of endometrial hyperplasia is a precursor of carcinoma

Answer 2

atypical

Question 3

how does endometrial hyperplasia present

Answer 3

abnormal bleeding (dysfunctional uterine bleeding or postmenopausal bleeding)

Question 4

what is the peak incidence age for endometrial carcinoma

Answer 4

50 - 60 years

Question 5

what are the 2 types of endometrial carcinoma

Answer 5

Type 1 = Endometrioid carcinoma

Type 2 = Serous carcinoma

Question 6

what is the precursor to Endometrioid carcinoma

Answer 6

atypical hyperplasia

Question 7

what is the precursor to serous carcinoma

Answer 7

serous intraepithelial carcinoma

Question 8

how does endometrial cancer typically present

Answer 8

with postmenopausal bleeding

• scanty and occasional
• may be associated with watery discharge

Question 9

what cell type are most endometrial carcinomas

Answer 9

adenocarcinoma

Question 10

what form of endometrial carcinoma is more common

Answer 10

Type 1 = endometrioid carcinoma [80%]

Question 11

what is endometrial carcinoma related to

Answer 11

unopposed oestrogen

Question 12

what are the risk factors that play the biggest role in Type 1

Answer 12

obesity

diabetes

Question 13

who is more likely to get Type 2 Serous tumours

Answer 13

elderly post menopause women

Question 14

what gene is often mutated in serous (and clear cell) tumours

Answer 14

TP53

Question 15

what mutations are associated with Type I tumours

Answer 15

PTEN, KRAS, PIK3CA mutations

Question 16

what is Lynch syndrome

Answer 16

cancer predisposition syndrome - high risk of colorectal, ovarian and endometrialcancer.

Question 17

what causes Lynch syndrome

Answer 17

inheritance of a defective DNA mismatch repair gene

- autosomal dominant inheritance

Question 18

how does serous type II tumours progress

Answer 18

spread along Fallopian tube mucosa and peritoneal surfaces

more aggressive than type 1

Question 19

what is serous carcinoma characterised by

Answer 19

complex papillary and/or glandular archietecture with diffuse, marked nuclear pleomorphism

Question 20

what is the stage of endometrial cancer

Answer 20

Stage I
- confined to uterus

Stage II
- tumour invades cervical stroma

Stage III
- Local and or regional tumour spread

Stage IV
- tumour invades bladder and/or bowel mucosa and/or distant mets

Question 21

what rare endometrium cancer is associated with adenomyosis and endometriosis

Answer 21

endometrial stromal sarcoma

Question 22

how does endometrial stromal sarcoma present

Answer 22

abnormal uterine bleeding + vaginal discharge in younger age group (45-50y/o)

Question 23

what is a malignant smooth muscle tumour that arises in the myometrium

Answer 23

leiomyosarcoma