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13 Cards in this Set
- Front
- Back
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a) What percentage of uterine cancer is non-adenocarcinoma (i.e. sarcoma, carcinosarcoma)?
b) What histologic sites of the uterus are affected? |
a) 8-10%
b) Myometrium (leimyosarcoma) Endometrium (stroma: ESS, well-diff ES, carcinosarcoma, adenosarcoma) [NOTE: MMMT has been reclassified as an epithelial cancer (carcinoma)] |
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List the different types of non-epithelial uterine cancer.
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Leiomyosarcoma
Carcinosarcoma (MMMT) Well-diff ES Endometrial stromal sarcoma Adenosarcoma [NOTE: MMMT has been reclassified as a carcinoma (e.g. epithelial) |
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a) List risk factors for non-adenocarcinoma uterine cancers.
b) List protective factors for the same. |
a)
Pelvic irradiation Black ethnicity (? incr. fibroids) Chronic estrogen exposure b) Smoking OCP use |
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What is the likelihood of diagnosing uterine sarcomas on pipelle biopsy?
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25-50%
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a) What uterine sarcomas/non-adenocarcinoma tumours fall into aggressive growth patterns?
b) Which have slow, indolent growth patterns? |
a)
Carcinosarcoma Undifferentiated ES Leimyosarcoma b) ESS STUMP Adenosarcoma Note: the first group have early LVSI and hematogenous spread and rapid disease progression despite therapy |
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a) How do leimyosarcomas typically spread: hematogenous or lymphatic?
b) How do carcinosarcomas typically spread: hematogenous or lymphatic? |
a) hematogenous - mets to lung most common
b) lymphatic - 30% with clinical stage I disease have positive LN |
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Describe the staging of leimyosarcoma.
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Stage I: confined to uterus
A: < 5cm B: > 5cm Stage II: confined to pelvis A: adnexal involvement B: extension to extrauterine pelvic sites Stage III: A: extension to abdominal site B: > 1 extension to abdominal site C: positive nodes Stage IV: A: invades bladder/rectum B: distant mets (inguinal, lung, liver, spleen, etc.) |
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Describe the staging of Carcinosarcoma.
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Same used as for Epithelial Endometrial cancer.
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Describe staging for adenosarcoma and ESS.
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Stage I: confined to uterus
A: limited to endometrium/endocervix, no myometrial invasion B: <= 50% myometrial invasion C: > 50% myometrial invasion Stage II: confined to pelvis A: adnexal involvement B: extension to extrauterine pelvic sites Stage III: A: extension to abdominal site B: > 1 extension to abdominal site C: positive nodes Stage IV: A: invades bladder/rectum B: distant mets (inguinal, lung, liver, spleen, etc.) |
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For which uterine sarcoma (non-adenocarcinoma) is nodal dissection at time of surgical treatment/staging required?
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Carcinosarcoma - 30% positive even if clinical stage I disease.
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How many patients after resection of primary uterine sarcoma and surgical stage I will experience relapse if observed only (no adjuvant treatment)?
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50%
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Besides chemotherapy, what medical treatment for ESS might be beneficial?
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Hormones (ER/PR positive)
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List features of leimyosarcoma
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mean age: 50
fast-growing, aggressive, high rate of relapse and death despite stage at diagnosis typically diagnosed at the time of surgery for benign fibroid disease |
