1 / 14

Malignant Lesions of The body of the Uterus

Endometrium - glands : adenocarcinoma - stroma: endometrial stromal sarcoma - glands stroma : MMMT Myometrium: - leomyomsarcoma - others . Endometrial

jela
Download Presentation

Malignant Lesions of The body of the Uterus

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. Malignant Lesions of The body of the Uterus

    3. Endometrial Carcinoma Peak incidence is at age of 61 years 75% occur in postmenopausal women Only 5% occur before age of 40 There is marked geographical and racial variation in the incidence

    4. Aetiology Excessive unopposed estrogen stimulation of the endometrium

    5. Aetiology Increase - Obesity Nulliparity Late menopause PCO Estogen-secreting ovarian tumors Unopposed estrogen therapy Family history of breast,ovary,colon,endometrial tumors DM Decrease OCCP progesterone

    6. Pathology Growth is usually adenocarcinoma Adeno-acanthoma/adenosquamous tumors Serous papillary/ clear cell Grade 1…………grade 3 Spread: - direct invasion - lymphatic - blood

    7. symptoms PMB Intermenstrual bleeding/irregular periods Heavy regular periods Watery discharge/offensive Pain ENDOMETRIAL BIOBSY SHOULD BE DONE IN ALL PATIENTS WITH PMB

    8. PHYSICAL SIGNS Rarely suggest the diagnosis Uterine enlargement Palpable lymph node in the groin.supraclavicle Vaginal nodule

    9. Diagnosis Always investigate PMB, continuous or irregular bleeding before assuming bengin cause for the bleeding Cervical smear TVS Endometrial biopsy Hysteroscopy +curettage If confirmed, CBC,KFT,URINE, MRI.CXR

    10. Prognosis Stage Grade Myometrial invasion Age Tumor size assessment of these factors require laparotomy and histology ( surgical pathological staging)

    11. Staging

    12. Treatment Low risk stage I: TAH, BSO High risk: postoperative radiotherapy Stage II: TAH,BSO+ radiotherapy/radical hysterectomy Stage III /IV: individualized .rarely surgery usually chemo, radiotherapy and hormonal Follow up Recurrence usually within 2 years(70%) Overall 5 year survival is 60%

    13. endometrial sarcoma Endometrial stromal sarcoma Malignant mixed mullerian tumors(carcinosarcoma) More in black. Previous pelvic irradiation Present with bleeding and pain Poor prognosis

    14. Leiomyosarcoma 5-10% May arise from transformation of fibromyoma(0.2%) Mostly arise from normal myometrium Peak incidence is 10 years older than finromyoma Present with abnormal bleeding and pelvic pain and wt loss Should be suspected in rapidly enlarging fibroids In 80%,diagnosis is made after hysterectomy Ideally should be treated by TAH,BSO,washing and full staging Adjuvant radiotherapy or chemotherapy?

More Related