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