medical notes

Apr 17th, 2015
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ENDOMETRIAL HYPERPLASIA AND CARCINOMAEssential of diagnosisAbnormal uterine bleeding, menorrhagia or post menopausal bleeding.Risk factorshyperoestrogenism - long-term exposure to unopposed oestrogens (polycystic ovarian syndrome, chronic anovulation, obesity, late menopause and exogenous oestrogens).Metabolic syndrome including diabetes and hypertension NulliparityIncreasing ageHistory of breast cancerGenetic predisposition (hereditary non-polyposis colon cancer syndrome)Diagnosisendometrial samplingultrasonographyAetiologymost endometrial carcinomas arise on background of endometrial hyperplasiatwo major typesType IAssociated with either endogenous or exogenous unopposed oestrogen exposureUsually consists of low grade or well differentiated tumour with a favourable prognosis.Type IIgrow independently of estrogen associated with endometrial atrophyeither poorly differentiated endometrial or non-endometrial tumourNB: - Oestrogen proliferates endometrium; progesterone antiproliferativeRisk of cancerRelated to both dose and duration of exposure.diminishes with cessation of oestrogen useSeems to be neutralized by addition of cyclic progestin for 10 days at least every 1 - 3 months.Surgical StagingIntroduced by FIGO and is based on abdominal explorationpelvic washingstotal hysterectomy with BSOSelective pelvic and peri-aortic lymph node biopsiesGrade of tumour included in staging description (architecture and nuclear atypia).architecture

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