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DU PA Gyn cancers

Duke PA Gyn cancers

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