Squamous cell carcinoma > adenocarcinoma of cervix
Common aetiology; HPV
Prevention available through Gardasil vaccine, occurrence correlated with; sexual activity, age of first intercourse & multiparity
Symptoms; vaginal bleeding, obstruction > fistula formation > secondary infection > purulent discharge
Diagnosis; via PAP smear
Prognosis; determined by four stages
Treatment; cauterisation, laser therapy, biopsy, conisation (stage 1), hysterectomy & radiotherapy (stage 2/3) & chemotherapy (stages 3/4)
Ectopic endometrium found outside uterine cavity
Histologically; appear as cystic sacs & solid spaces, glands & stroma visible
Presents with; fibrosis w/ repeated inflammation & organisation
Types; Endometriosis interna/adenomyosis (in myometrium) or endometriosis externa (outside uterine wall)
Aetiological theories; 1. retrograde menstruation 2. metaplasia theory 3. metastatic theory
Symptoms; usually asymptomatic/slight pain, menstrual discomfort & more severe symptoms (dysmenorrhoea, dyspareunia, dyschezia, dysuria, menorrhagia, haemochezia, haematuria, diarrhoea etc
Treatment; hormonal manipulation
Types; 1. occurs close to menopause (most common, good prognosis) & 2. occurs in older post-menopausal women (poor prognosis)
Aetiology; hyperoestrinism, obesity, infertility/nulliparity, genetic factors
Symptoms; abnormal bleeding, leucorrhoea, painful/tender uterus
Treatment; surgery, radiotherapy or chemotherapy
Prognosis; very good if detected in early stages
Most common benign tumour of genital tract
Oestrogen-dependant, not premalignant
Types; submucosal, transmural & subserosal
Symptoms; dysmenorrhoea, menorrhagia, discomfort, obstruction/pressure effects on bladder/bowel
Treatment; surgical excision or hysterectomy
Often benign, very common, derive from graafian follicles or surface epithelium
Stein-Leventhal syndrome; characterised as polycytic ovarian syndrome (Three theories - 1. HPA defect 2. ovarian steroid genesis defect 3. insulin resistance in peripheries
Associated with; obesity, hirsutism (excessive hair growth), irregular periods or amenorrhoea (absent periods) = reduced fertility
Treatment; exogenous hormone administration
Commonly derived from surface epithelium, sex cord & stromal cells and germ cells
Types; epithelial tumours, tubal differentiation (serous ovarian tumours), endocervical differentiation (mucinous ovarian), endometrial differentiation (endometrioid/clear-cell ovarian; clear cytoplasm), transitional differentiation (Brenner ovarian; UTI like infection)
Serous cystadenocarcinoma = most common ovarian malignancy (poor prognosis; 5y/s/r = 20%)
Pre-eclampsia; presents with high BP, proteinuria & peripheral oedema, rarely fatal to mother (reduced placental blood flow/foetal hypoxia), HT & DM predispose
Eclampsia; may follow pre-eclampsia or de novo, if untreated may be fatal to both mother & foetus
Ectopic; fertilised ovum implants outside uterus (most commonly in fallopian tube) > acute abdomen presentation > tubal rupture
Placental abruption; separation of normally located placenta > abdominal pain/haemorrhage > still birth/maternal death
Placental previa; low implantation of placenta in uterus > antepartum haemorrhage/obstructed labour (four grades of placental previa)
I; encroaches lower segment but does not reach internal OS, II; occupies lower segment with edge reaching internal OS, III; implanted in lower segment & partly cover internal OS, IV; implanted in lower segment & completely covers internal OS
Rubella virus; crosses placenta > congenital malformation
Listeria monocytogenes; crosses placenta > necrosis of internal organs (in cold meats, soft cheeses etc)
N. Gonorrhoea; infected birth canal > opthalmia neonatorum (conjunctivitis)
Treponema pallidum (Syphilis); crosses placenta > spontaneous abortion/congenital syphilis
Toxoplasma gondii; crosses placenta > spontaneous abortion/still birth OR microcephaly/hydrocephaly
- Leads to cyst formation
From cats, cleaning cat litter etc
HIV; crosses placenta or birth/lactation acquired > AIDS
M. Tuberculosis; crosses placenta > foetal tuberculosis
Fibroadenoma; most common benign lump (firm, rubbery, well-circumscribed > highly mobile/solitary lump)
Carcinoma of the breast; aetiological factors include oestrogen exposure & genetics, geographic & dietary factors, epithelial hyperplasia, early menarche, nulliparity, late menopause & exogenous hormones
Presents as; 1. Palpable lump 2. anomaly detected via mammograph 3. incidental histological finding following removal of another 4. detection of metastatic deposits in other organs
1. Non-invasive ductal carcinoma in situ (DCIS); detected as palpable lump/mammograph, Paget's disease of the nipple (spread of DCIS to skin), presents with reddening, thickening, scaling of nipple & areola skin (like eczema)
2. Non-invasive lobular carcinoma in situ (LCIS); detected via mammography (not usually palpable, no ducts involved, increases risk of invasive adenocarcinoma
3. Invasive ductal carcinoma (from ducts); most common, presents with island cells & dense fibrous stroma
4. Invasive lobular carcinoma (arise from lobular glands); presents as narrow cords of cell & dense fibrous stroma
5. Tubular carcinoma; well differentiated cells forming regular tubular structures, better prognosis
6. Mucoid carcinoma (Colloid carcinoma); cells secrete mucous into stroma, soft/slimy texture, well differentiated, better prognosis
7. Medullary carcinoma; well circumscribed masses > soft/fleshy texture, dense lymphocytic infiltrate
Spread; 1. Local (deep fixation > requires radical mastectomy) 2. Lymphatic ("orange peel effect", dimpling appearance) 3. Vascular (to bone, lung, pleura, ovaries & liver)
Diagnosis; breast self examination, mammography, biopsy
Treatment; lumpectomy, mastectomy, radiotherapy, chemotherapy, hormone therapy
Prognosis; stage 1 (confined to breast) 2. confined to breast/lymph nodes 3. deep tissue fixation 4. distant metastases
Also, based on molecular classification (expression of ER (oestrogen receptor) & HER-2 (human epidermal growth factor receptor 2 > worst prognosis)