L3 (T3): Endometrial carcinoma

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Questions and Answers

What is the most common type of adenocarcinoma in endometrial cancer?

  • Clear cell adenocarcinoma
  • Serous adenocarcinoma
  • Endometrioid adenocarcinoma (correct)
  • Squamous cell adenocarcinoma

What staging system is usually used for gynaecological tumors like endometrial carcinoma?

  • FIGO staging system (correct)
  • TNM staging system
  • Brussels staging system
  • Lyon staging system

What is the precursor lesion of endometrioid cancer?

  • Atypical hyperplasia (correct)
  • Dysplasia
  • Carcinoma in situ
  • Metaplasia

What is the most common symptom of endometrial cancer?

<p>Postmenopausal bleeding (D)</p> Signup and view all the answers

What is the main factor contributing to the higher mortality rate in African American women with endometrial carcinoma?

<p>Later stage at diagnosis (D)</p> Signup and view all the answers

What does tumor grading in endometrial carcinoma reflect?

<p>Degree of resemblance to parent tissue (D)</p> Signup and view all the answers

Which factor has been contributing to the increasing incidence of endometrial cancer in the last ten years?

<p>Excess body weight (A)</p> Signup and view all the answers

What is the most common presentation of endometrial cancer in women?

<p>Postmenopausal bleeding (A)</p> Signup and view all the answers

What is the primary method for grading neoplasms like endometrial carcinoma?

<p>Microscopic examination of tissue (D)</p> Signup and view all the answers

What is the primary risk factor for endometrial cancer among the listed options?

<p>Excess body weight (C)</p> Signup and view all the answers

What do over 80% of women with endometrial cancer present with?

<p>Postmenopausal bleeding (D)</p> Signup and view all the answers

Is endometrial cancer considered as one disease or several?

<p>Several (D)</p> Signup and view all the answers

Can a preinvasive dysplastic lesion be recognized in endometrial cancer?

<p>Yes (A)</p> Signup and view all the answers

What factors inform the behavior of endometrial cancer?

<p>Parameters which predict behavior (B)</p> Signup and view all the answers

What is the age standardized incidence rate of endometrial cancer in the UK from 1993-2016?

<p>Not provided (C)</p> Signup and view all the answers

What is the primary symptom of endometrial cancer?

<p>Postmenopausal bleeding (B)</p> Signup and view all the answers

What aspect defines subtypes of endometrial cancer?

<p>Appearance or molecular profile (C)</p> Signup and view all the answers

What is the focus of learning in relation to endometrial cancer?

<p>Evaluation of parameters predicting behavior (D)</p> Signup and view all the answers

What is the most common presentation of endometrial cancer?

<p>Postmenopausal bleeding (D)</p> Signup and view all the answers

What is the risk factor for over 80% of women with endometrial cancer?

<p>Postmenopausal status (D)</p> Signup and view all the answers

What is the most common subtype of endometrial adenocarcinoma?

<p>Endometrioid (A)</p> Signup and view all the answers

Which syndrome is a familial syndrome associated with an increased risk of endometrial adenocarcinoma?

<p>Lynch syndrome (C)</p> Signup and view all the answers

What is the lifetime risk of developing endometrial adenocarcinoma in women?

<p>1 in 46 (B)</p> Signup and view all the answers

Which factor reduces the risk of endometrial cancer?

<p>Pregnancy and parity (B)</p> Signup and view all the answers

What is the classification system used by The Cancer Genome Atlas (TCGA) for endometrial cancers based on?

<p>Integrated genomic, transcriptomic, and proteomic characterizations (B)</p> Signup and view all the answers

Which type of hormone replacement therapy is associated with an increased risk of endometrial adenocarcinoma?

<p>Unopposed estrogen therapy (A)</p> Signup and view all the answers

What is the assumed origin of precursor lesions for endometrial adenocarcinoma?

<p>Atypical hyperplasia (C)</p> Signup and view all the answers

Which factor is not associated with an increased risk of endometrial adenocarcinoma?

<p>Pregnancy (B)</p> Signup and view all the answers

What is the most common invasive cancer of the female genital tract in the UK?

<p>Endometrial adenocarcinoma (D)</p> Signup and view all the answers

Which subtype of endometrial adenocarcinoma is named based on its microscopic appearance?

<p>Clear cell (B)</p> Signup and view all the answers

What is the stage of physical maturation in an individual when they become physiologically capable of procreation?

<p>Puberty (A)</p> Signup and view all the answers

What are the common disorders of puberty?

<p>Early and delayed puberty (D)</p> Signup and view all the answers

What is important to determine in clinic when assessing pubertal development in children?

<p>Comparison with national averages (C)</p> Signup and view all the answers

What is the primary purpose of covering the normal range of puberty?

<p>To identify abnormalities (B)</p> Signup and view all the answers

What are the primary physical changes associated with puberty?

<p>Voice deepening and breast development (D)</p> Signup and view all the answers

What is the physiological capability achieved during puberty?

<p>Fertility (A)</p> Signup and view all the answers

What controls puberty in the brain?

<p>The pituitary gland (C)</p> Signup and view all the answers

What is a possible cause of early pubic hair development in girls?

<p>Adrenal androgen activation (A)</p> Signup and view all the answers

What is the significance of recognizing a growth spurt in children?

<p>It indicates early puberty (D)</p> Signup and view all the answers

What can early breast development in girls indicate?

<p>Early puberty (A)</p> Signup and view all the answers

What is the connection between pubic and axillary hair and puberty?

<p>Connected to adrenal hormones (A)</p> Signup and view all the answers

What is the role of non-pediatricians in recognizing abnormal growth patterns?

<p>Crucial role (C)</p> Signup and view all the answers

What is a crucial indicator of imminent menarche in girls?

<p>Breast stage four (A)</p> Signup and view all the answers

What can lead to early menarche, necessitating brain MRI and further investigation?

<p>Pituitary hypothalamic activation and acute conditions (B)</p> Signup and view all the answers

What may indicate underlying health issues if it occurs without other signs of puberty in girls?

<p>Menstruation (A)</p> Signup and view all the answers

What is affected by overnourishment and nutrition, leading to precocious puberty?

<p>Puberty and adrenal development (A)</p> Signup and view all the answers

What is essential to determine in endocrinology, as some conditions mimic its activation without actually initiating it?

<p>Whether the puberty axis is activated or not (B)</p> Signup and view all the answers

What is crucial in endocrinology, as they vary throughout the day and are affected by circadian rhythms?

<p>Understanding hormonal patterns (B)</p> Signup and view all the answers

In boys, what is the determining factor for puberty?

<p>Testicular volume (D)</p> Signup and view all the answers

What is the role of adrenal function in cases of concerns about precocious puberty?

<p>It is crucial to test adrenal function, especially in cases of concerns about precocious puberty without typical signs (B)</p> Signup and view all the answers

What does an advanced bone age in a child indicate?

<p>Exposure to hormones, as seen in a case of congenital adrenal hyperplasia (CAH) (D)</p> Signup and view all the answers

What is the significance of multi-hormonal issues in the pituitary gland?

<p>They can present clues to underlying conditions (A)</p> Signup and view all the answers

Why is it essential to consider a comprehensive approach in evaluating cases of delayed or precocious puberty?

<p>To include adrenal function and dynamic testing (A)</p> Signup and view all the answers

What do normal gonadotropin levels in response to stimulation indicate?

<p>A lower likelihood of congenital problems (C)</p> Signup and view all the answers

What is the primary cause of congenital hypogonadism in boys?

<p>Pituitary problem affecting LH and FSH production (A)</p> Signup and view all the answers

What is the crucial factor for pubertal development in boys?

<p>Presence of testes (C)</p> Signup and view all the answers

What is the role of estrogen in determining growth and development in puberty for girls?

<p>Breast development and uterine transformation (D)</p> Signup and view all the answers

What can be used to identify the genes responsible for congenital hypogonadism?

<p>Gene panel studies (D)</p> Signup and view all the answers

What is important to monitor in order to understand the effects of hormones on growth and development?

<p>Stages of the ovarian cycle (B)</p> Signup and view all the answers

What is crucial for protecting the height and exposure to androgens in young boys?

<p>Puberty blockers (C)</p> Signup and view all the answers

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Study Notes

Endometrial Adenocarcinoma and its Subtypes

  • The endometrium is composed of glands in a specialized stroma with a specialized blood supply, and its growth, maturation, and regression are coordinated during each menstrual cycle.
  • The predominant endometrial cancer arises from the glands of the endometrium, specifically as adenocarcinoma, a malignant neoplasm of glandular epithelium.
  • Adenocarcinomas arising at different sites in the body have different risk factors, pathogenesis, appearances, genetic abnormalities, behavior, prognosis, and treatment.
  • Subtypes of endometrial adenocarcinoma include endometrioid, serous, clear cell, mixed, undifferentiated/dedifferentiated, and carcinosarcomas, each with distinct morphological characteristics.
  • Endometrioid adenocarcinoma is named for its resemblance to normal endometrial glands, while serous and clear cell adenocarcinomas are named based on their respective microscopic appearances.
  • Different subtypes of adenocarcinoma with similar appearances and names occur at other sites, making it difficult to determine the site of origin and metastasis in case of spread.
  • The Cancer Genome Atlas (TCGA) has classified endometrial cancers into four groups based on integrated genomic, transcriptomic, and proteomic characterizations, revealing different mutation patterns and frequencies.
  • Precursor lesions for endometrial adenocarcinoma are assumed to originate from atypical hyperplasia, supported by genetic and morphologic continuity with endometrioid endometrial adenocarcinoma.
  • Endometrial adenocarcinoma is the most common invasive cancer of the female genital tract in the UK and the fourth most common cancer in women, with a lifetime risk of 1 in 46, usually occurring in postmenopausal women.
  • Risk factors for endometrial adenocarcinoma include endogenous hormones, excess body weight, diabetes mellitus, exogenous hormones, ethnicity, and familial syndromes such as Lynch syndrome and Cowden’s syndrome.
  • Factors such as excess body weight, diabetes mellitus, and late menopause increase the risk of endometrial cancer, while pregnancy and parity reduce the risk.
  • Hormone replacement therapy with unopposed estrogen and the use of tamoxifen are associated with an increased risk of endometrial adenocarcinoma.

Endocrinology Lecture Overview

  • Puberty blockers are necessary for young boys to protect their height and exposure to androgens and puberty hormones.
  • Enlargement of testes is crucial for androgen production and pubertal changes in boys.
  • Adrenals can cause damage even when testes are small.
  • It is important to ensure that boys with pubertal development issues do not have fertility problems later on.
  • Congenital hypogonadism, also known as hypo kapok, is caused by a pituitary problem affecting LH and FSH production.
  • Gene panel studies can be used to identify the genes responsible for congenital hypogonadism.
  • Different spectrums of congenital hypogonadism can lead to varying growth, puberty, and fertility issues.
  • In boys, pubertal development is dependent on the presence of testes.
  • Understanding the stages of the ovarian cycle is important to monitor hormone levels and their effects on growth and development.
  • Estrogen plays a crucial role in determining growth and development in puberty, including breast development and uterine transformation.
  • The shape and condition of the uterus can be influenced by exposure to estrogen and gonadotropins.
  • Adolescence can cause erratic cycles for years, and endocrinologists need to consider this when assessing puberty-related issues.

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