FMGE 2023 Classes at Top Residential Coaching Centre
Obstetrics and Gynecology
Topic: Endometrial Cancer
Kings International Medical Academy offers top-notch FMGE coaching and appoints eminent doctors from India to act as faculty members for our students. One of our esteemed educators, Dr. Vidhya, delivers captivating lectures on Obstetrics and Gynecology, providing our students with a thorough understanding of the subject. Today, we will delve into the topic of Endometrial Cancer and explore it comprehensively.
ENDOMETRIAL CANCER
Premalignant lesion: Endometrial hyperplasia
MC Sx: Post menopausal bleeding (PMB)
MCC for SX: Endometrial atrophy 60%(senile endometriosis)
*TAMOXIFEN cause endometrial CA
MC HNPCC (lynch2) cancer in femals: Endometrial CA (60%)
SPORADIC CA - 90% FAMILIAL CA: 10%
| I | CONFINED TO UTERUS | ||
| IA | <50% myo (No adjuvant Tx need) | FOLLOW UP | |
| IB | >50% myometrium | Adjuvant CHEMO + RADIO | |
| II | CERVICAL INVOLVEMENT | ||
| IIA | Endocervical glandular involve | ||
| IIB | Cervical stromal invasion | ||
| III | Peritoneum and Nodes | ||
| IIIA | +ve peritoneal cytology / uterine serosa invasion or adnexal involve | ||
| IIIB | VAGINA / Parametrium involve | ||
| IIIC | C1: Pelvic LN C2: Para aortic LN | ||
| IV | |||
| IVA | Bladder / Bowel involved | ||
| IVB | Distant metastasis | Adj CHEMO | |
| Dx: Staging Laparotomy: Midline vertical incision --> Inspect organs Ascites - take cytology (if no ascites-> saline - peritoneal wash) TOTAL ABD HYSTERECTOMY + B/L SalphingoOophorectomy Metastasis >1cm - remove Intracolic omentectomy --> biopsy Lymph nodes (pelvic+paraaortic) - remove | |||
Types of Endometrial Hyperplasia: (Premalignant lesions)
| Malig risk | ||
| Simple w/o atypia | 1% | Progesterone therapy |
| Complex w/o atypia | 3% | |
| Simple with atypia | 8% | Hyterectomy |
| Complex with atypia | 29% |
Endometrial cancer:
| Type 1 | Type 2 |
| (ENDOMETRIOID) 80% | (Non-endometrioid)20% |
| WHITE woman Estrogen dependent (+) Pre-existing lesion (+) Good prognosis (+) PERI menopause KRAS, BRAF mutation MCType:ADENOCARCINOMA |
BLACK women (-) (-) (-) POST Menopause P53 mutation (high grade) Others: SQUAMOUS, serous, mucinous, clear cell, mixed, undifferentiated/unclassified |