Medicine an Surgery notes

Apr 24th, 2015
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UTERINE CARCINOMADR. SALWA NEYAZICONSULTANT OBSTETRICIAN GYNECOLOGISTPEDIATRIC & ADOLESCENT GYNECOLOGIST1-ENDOMETRIAL HYPERPLASIA &CARCINOMAEndometrial cancer is the most common pelvic genitalcancer in womenIn the US the life time risk of developing endometrial Cais 2.4% in white women & 1.3% in blackIt is a disease of postmenopausal women with a peakincidence in the 6th & 7th decade of lifeOnly 2-5% occur before 40 yearsPrognosis is better than other Gynecological Ca due toearly Dx ---75% Dx Stage IEstrogen has been implicated as a causative factorRISK FACTORSAge65-75 Y , only 2-5% < 40 Y Excessive endogenous / exogenous estrogens-Early menarche < 12 Y- Late menopause > 52 Y 2 X risk-Nulliparity 2X > women with 1 child / 3X > women with 5-Chronic anovulation as in PCO-Obesity aromatization of adrenal androgens in fat tissuerisk is 3X for Pt 21-50 pounds overweight10 X for Pt > 50 P overweight-Granulosa-thicka cell tumors of the ovary (a rare estrogensecreting ovarian tumor) endometrial hyperplasia & Cain 10% of Pt-Cirrhosis of the liver degradation of estrogen-Endometrial hyperplasiaRISK FACTORSUnopposed estrogen therapy in postmenopausal women risk of E Ca 6-8 XTamoxifen an anti-estrogen used in the Rx of breastCa has weak estrogenic activity on the genital tract2 X risk of E Ca when used 5 Y risk in women with br

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