En Dome Trial Cancer
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Transcript of En Dome Trial Cancer
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Most common invasive cancer of the
female genital tract
Arise mainly in Postmenopausal WomenUncommon in women younger than 40
years of age
Peak Incidence: 55-65 year old women
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Characteristics Type I Type II
Age 55-65 yr 65-75
Clinical Setting Unopposed
estrogenObesityHypertensionDiabetes
Atrophy
Thin physique
Morphology Endometrioid SerousClear CellMixed Mullerian
Tumor
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Characteristics Type I Type II
Precursor Hyperplasia Endometrialintraepithelial
carcinomaMolecular genetics PTEN
PIK3CAKRASMSIB-cateninP53
P53AneuploidyPIK3CA
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Characteristics Type I Type II
Behavior IndolentSpreads via
lymphatics
AgrgressiveIntraperitoneal and
lymphatic spread
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Localized as polypoidtumor or diffusetumor involving
endometrial surface Spread generally by
Direct myometrial
invasion witheventual extension tothe periuterinestructures by directcontinuit
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Localized as polypoidtumor or diffusetumor involving
endometrial surface Spread generally by
Direct myometrial
invasion witheventual extension tothe periuterinestructures by directcontinuit
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Spread into broad ligaments Palpable Mass Dissemination to the regional lymph nodes May metastasize to the lungs, liver, bones and
other organs
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ENDOMETRIOID ADENOCARCINOMA
85% of Endometrial Carcinomas Gland Patterns resembling normal endometrial
epithelium
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COMPLEX ATYPICAL HYPERPLASIA- very closelypacked irregular-shaped endometrial glandseparated by hyperplastic endometrial stroma
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ENDOMETRIOID CARCINOMA
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Dilated irregular glands
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Grade I. Well Differentiated adenocarcinoma, lessthan 5% solid growth
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Grade II. Moderately differentiatedadenocarcinoma with partly (less than 50%) solidgrowth
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Grade III. Poorly differentiated adenocarcinomawith predominantly solid growth (greater than50%)
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SEROUS CARCINOMA
most common
subtype
Clear cell carcinoma and Malignant Mixed
Mullerian Tumor
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confluent glandularpattern
cribriform pattern
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Papillary pattern
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Infiltrationof glands
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Arise from small uteri Often bulky tumors
Deeply invasive into myometrium Precursor lesion: ENDOMETRIAL
INTRAEPITHELIAL CARCINOMA Invasive lesions Papillary Growth Pattern
Cells with marked atypia (high nuclear tocytoplasmic ratio, atypical figures,heterochromasia and prominent nucleoli.
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What are the important features identified onthe hysterectomy specimen in evaluating
prognosis?
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The prognosis depend heavily on the clinicalstage of the disease and its histologic grade
and type Hysterectomy specimens with endometrial
carcinoma are often submitted for frozensection to determine the depth on invasion.
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Clinicians ask for the involvement of thecervix uteri and the ovaries.
The pathologic examination of the uterus andadnexa is necessary for final staging on thepostoperative specimen
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In that process, the ff are taken: weight and the size of the uterus and adnexa appearance of the serosal surface, the myometrium,
and the uninvolved endometrium The uterine tumor should be described
location
3-dimensional size
distance from the margins and from the external oa descriptive characteristics (eg, exophytic, necroses, color)
estimated depth of infiltration into the myometrium, andits infiltration of the cervix
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What is the relationship of parity, age,exogenous estrogen administration to the
development of the endometrium?
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Clinicopathologic and epidemiologic studies
have supported the malignant of endometrialhyperplasia and the concept of a continuumof proliferative glandular lesions culminatingin some cases, in carcinoma.
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Furthermore, molecular studies haveconfirmed that endometrial hyperplasia andcarcinoma have specific molecular geneticalterations.
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Therefore, since the following factors
mentioned (parity, age, exogenous estrogenadministration ) are also closely related toendometrial hyperplasia, its safe to say thatthis factors can also contribute toendometrial carcinoma.
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Why did this patient receive internal radiumradiation
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THANKYOU!
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A malignant mixed Mllerian tumor, also known asmalignant mixed mesodermal tumor, MMMT andcarcinosarcoma, is a malignantneoplasm found in theuterus , the ovaries, the fallopian tubes and other
parts of the body that contains bothcarcinomatous(epithelial tissue) and sarcomatous (connective tissue)components. It is divided into two types, homologous(in which the sarcomatous component is made oftissues found in the uterus such as endometrial,fibrous and/or smooth muscle tissues) and aheterologous type (made upof tissues not found inthe uterus, such as cartilage, skeletal muscle and/orbone).
http://en.wikipedia.org/wiki/Carcinosarcomahttp://en.wikipedia.org/wiki/Malignancyhttp://en.wikipedia.org/wiki/Neoplasmhttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Carcinosarcomahttp://en.wikipedia.org/wiki/Malignancyhttp://en.wikipedia.org/wiki/Neoplasmhttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Carcinomahttp://en.wikipedia.org/wiki/Epitheliumhttp://en.wikipedia.org/wiki/Sarcomahttp://en.wikipedia.org/wiki/Connective_tissuehttp://en.wikipedia.org/wiki/Connective_tissuehttp://en.wikipedia.org/wiki/Connective_tissuehttp://en.wikipedia.org/wiki/Epitheliumhttp://en.wikipedia.org/wiki/Sarcomahttp://en.wikipedia.org/wiki/Connective_tissuehttp://en.wikipedia.org/wiki/Homology_(biology)http://en.wikipedia.org/wiki/Homology_(biology)http://en.wikipedia.org/wiki/Homology_(biology)http://en.wikipedia.org/wiki/Endometriumhttp://en.wikipedia.org/wiki/Fibrous_connective_tissuehttp://en.wikipedia.org/wiki/Smooth_musclehttp://en.wikipedia.org/wiki/Cartilagehttp://en.wikipedia.org/wiki/Skeletal_musclehttp://en.wikipedia.org/wiki/Bonehttp://en.wikipedia.org/wiki/Cartilagehttp://en.wikipedia.org/wiki/Skeletal_musclehttp://en.wikipedia.org/wiki/Bonehttp://en.wikipedia.org/wiki/Bonehttp://en.wikipedia.org/wiki/Skeletal_musclehttp://en.wikipedia.org/wiki/Cartilagehttp://en.wikipedia.org/wiki/Smooth_musclehttp://en.wikipedia.org/wiki/Fibrous_connective_tissuehttp://en.wikipedia.org/wiki/Endometriumhttp://en.wikipedia.org/wiki/Homology_(biology)http://en.wikipedia.org/wiki/Connective_tissuehttp://en.wikipedia.org/wiki/Sarcomahttp://en.wikipedia.org/wiki/Epitheliumhttp://en.wikipedia.org/wiki/Carcinomahttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Neoplasmhttp://en.wikipedia.org/wiki/Malignancyhttp://en.wikipedia.org/wiki/Carcinosarcoma