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DU PA Gyn cancers
Duke PA Gyn cancers
| Question | Answer |
|---|---|
| most common Gyn cancer | endometrial carcinoma |
| endometrial carcinoma has a __ prognosis | favorable (esp if estrogen-dependent) |
| 2nd most common Gyn malignancy, most common cause of death due to Gyn cancer b/c it is caught late | ovarian cancer |
| 90% of ovarian cancers are __ tumors | epithelial |
| ovarian cancer risk factors | family hx, hx of breast cancer, nulliparity or poor reproductive hx, infertility, early menarche/late menopause, genetics, PCOS, endometriosis, obesity |
| protective factors for ovarian cancers | oral contraceptives, multiparity, tubal ligation, breastfeeding |
| symptoms of ovarian malignancy | vague, pelvic pain/bloating/urinary tract symptoms, clothing too tight/abdomen enlarging |
| PE of a mass that is probably benign | mobile, cystic, unilateral, smooth |
| PE of a mass that is possibly malignant | fixed, solid, bilateral, nodular |
| ultrasound of a mass that is probably benign | <10 cm, minimal septations, unilateral |
| ultrasound of a mass that is possibly malignant | >10 cm, solid, multiple septations >3mm, bilateral, ascites, doppler blood flow? |
| Fiery red lesions with white hyperkeratotic areas: | Paget dz (usu >65 yo; underlying colon/Br Ca) |
| Paget dz tx | wide local excision or vulvectomy |
| melanoma of vulva | Raised, irritated, pruritic, pigmented lesion; 5% of vulvar malig; wide local excision; must do bx; Avoid tanning booths! |
| Most common vulvar ca | Epidermoid (usu menopausal but can be 30-40) |
| Vulvar ca | Pruritus; Usually Red or white ulcerative or exophytic lesion; Posterior 2/3 of labium majorus; often a delay in tx |
| Vulvar ca progression | Localized for long period, then spreads lymphatically; Inguinal lymphadenopathy; If anterior 2/3 of vulva: may spread to deep lymphatics in pelvis |
| Vulvar ca: dx & tx | Bx; CXR, IVP, cysto, procto; radical vulvectomy, node dissection; adjunct postoperative radiation; 5 yr 75% |
| Vaginal ca: clin presentation | abnormal bleeding, pain, mass, dyspareunia |
| Vaginal Ca RFs | HPV (squamous cell); DES (clear cell) |
| Vaginal Ca tx | Colposcopy, bx: excision |
| Endometrial ca: estrogen-independent | Thin, older postmenopausal women without unopposed estrogen; atrophic, spontaneous; poorer prognosis |
| For any woman >35 y.o. with abnormal bleeding: | EMB (endometrial bx) (D&C and hysteroscopy) |
| Endometrial ca: tx | Surg tx (cornerstone): TAH/BSO (bilateral salpingo-oophorectomy); node dissection? Post-op radiation, medroxyprogesterone for recurrence |
| Endometrial ca Eval | TV US: >5 mm stripe: needs bx (EMB) (<5 mm does not r/o non-estrogen-dependent ca) |
| Ovarian ca: tx | TAH/BSO; surgical staging; chemo |
Created by:
bwyche
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