This document discusses endometrial carcinoma (cancer of the uterine lining). It covers the types of endometrial hyperplasia (non-cancerous overgrowth), types of endometrial cancer including the most common type, and clinical features such as postmenopausal bleeding. Investigations like transvaginal ultrasound, endometrial biopsy and MRI are discussed. Treatment options include surgery such as hysterectomy for early stages and hormone therapy or radiation for some pre-cancerous lesions or advanced cases. Prognosis depends on cancer stage, with 5-year survival rates ranging from 75% for stage I to 10% for stage IV disease.
Endometrial Cancer is a malignancy that arises from the lining of the uterus, endometrium.
It is the most common gynaelogical cancer in developing countries, while in developed countries it is the second most common cancer, behind cervical cancer.
• In year 2012 a total of 320,000 new cases were recorded.
• Globally, it is the sixth most common cancer in women, fourteenth most common overall.
• In Peninsular Malaysia, it is the seventh most common cancer in women, according to Malaysian cancer Registry 2006.
• It is rare among women younger than 40 years.
• Peak incidence occurring at age 60-69.
• Majority are of Chinese ethnicity (47.5%), followed by Malays (41.6%) and Indian (10.9%).
a nice presentation about the Ovarian Cancer its include an introduction with brief notes about the epidemiology and risk factors then shift to pathology and pathogenesis and diagnosis with signs , symptoms and lab tests with imaging modules , screening , management
Endometrial Cancer is a malignancy that arises from the lining of the uterus, endometrium.
It is the most common gynaelogical cancer in developing countries, while in developed countries it is the second most common cancer, behind cervical cancer.
• In year 2012 a total of 320,000 new cases were recorded.
• Globally, it is the sixth most common cancer in women, fourteenth most common overall.
• In Peninsular Malaysia, it is the seventh most common cancer in women, according to Malaysian cancer Registry 2006.
• It is rare among women younger than 40 years.
• Peak incidence occurring at age 60-69.
• Majority are of Chinese ethnicity (47.5%), followed by Malays (41.6%) and Indian (10.9%).
a nice presentation about the Ovarian Cancer its include an introduction with brief notes about the epidemiology and risk factors then shift to pathology and pathogenesis and diagnosis with signs , symptoms and lab tests with imaging modules , screening , management
This is a PowerPoint presentation on Ovarian Cancer that was completed in my medical coding course this semester. We were to code all diagnoses, symptoms, and procedures that we shared.
A lecture on endometrial hyperplasia and carcinoma, exploring the etiology, clinical features, types, investigations, management and treatment options and prognosis.
This was presented to undergraduate medical students at Livingstone Central Teaching Hospital, Livingstone, Zambia, department of Obstetrics and Gynecology by Nghitukuhamba T.E Kalipi (final year student) Cavendish University Zambia, School of Medicine.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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- Prix Galien International Awards Ceremony
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. 1. What are types of endometrial hyperplasia?
2. What are types of endometrial ca and the
commonest type?
3. What are the clinical features ?
4. What are the investigations that should be done?
5. In which lesion spontaneous regression is possible?
6. What is mode of treatment?
3. 1. Simple endometrial hyperplasia without atypia
Complex endometrial hyperplasia without atypia
Simple endometrial hyperplasia with atypia
Complex endometrial hyperplasia with atypia
2. adenocarcinoma,serous ca,clear cell adenocarcinoma,secondary
metastasis
3. postmenopausal bleed,offensive vaginal discharge,pelvis discomfort
4. tvs,pelvic examination,endometrial biopsy(pipelle
sampling),hysteroscopy,cxr,MRI
5. simple hyperplasia without atypia
6. surgical/hormonal
Thorough intraperitoneal exploration
Peritoneal washing
Extrafascial hysterectomy and bilateral salphingoophorectomy
Pelvic with or without paraaortic lymphadenectomy
Omentectomy- in advanced cases if omentum is involved
5. 5
Diagnosis:
Primary assessment in all cases is with transvaginal
ultrasound and pelvic examination.
All postmenopausal patients with an endometrial
thickness >5mm or persistent bleeding despite a normal
endometrial thickness should have an endometrial biopsy
If the endometrium is difficult to identify then
hysteroscopy should be considered.
The value of endometrial thickness in perimenopausal
bleeding is questionable as the thickness range is
variable.
Hysteroscopy should be used as a diagnostic tool only
when ultrasound results are inconclusive
6. 6
Clinical features
>90%: postmenopausal bleeding.
Usually 20% of those who come with post
menopausal bleed will have a carcinomatous
origin. Out of those, 50% will be due to
endometrial carcinoma.
offensive vaginal discharge
Discomfort in the pelvis (not always)
Uterine enlargement in advanced disease
Vaginal metastases particularly in the lower
third.
7. 7
INTRODUCTION
Endometrial carcinoma is the commonest
gynaecological cancer in the developed world with
a rising incidence in postmenopausal women.
The crude incidence of endometrial carcinoma in
the European Union is 16 cases/100 000
women/year
Uterine cancer effects the lining of the uterus
(endometrium). It is the fourth most common
cancer in women in Peninsular Malaysia.
8. 8
Endometrial
carcinoma
Type 1
- Related to hyperestrogenism associated
with endometrial hyperplasia
- Frequent expression of estrogen and
progesterone
- Younger age
Type 2
- Unrelated to estrogen associated with
atrophic endometrium
- Lack of estrogen and progesterone
receptors
- Older age
9. 9
Risk factors:
age: peak (65-75 years old)
Obesity[rcog]
nulliparity
late menopause
polycystic ovary syndrome
Estrogen replacement therapy
Chronic diseases: DM, hypertension
family history of endometrial, ovarian or intestinal
malignancy
past history of breast, ovarian or intestinal malignancy.
10. 10
Endometrial hyperplasia
Classification of endometrial hyperplasia %
Simple endometrial hyperplasia without atypia 1
Complex endometrial hyperplasia without atypia 3
Simple endometrial hyperplasia with atypia 8
Complex endometrial hyperplasia with atypia 29
11. 11
Histopathology:
1. Endometriod adenocarcinoma
Most common type ~75-80%
2. Serous carcinoma
~10% of all cases
Has papillary growths which resembles serous
carcinoma of ovary and Fallopian tubes
3. Other cell types
4%-Clear cell adenocarcinoma
Secondary metastasize from breast, stomach, colon,
pancreas, kidney, ovary
12. 12
Investigations:
After confirming the diagnosis the objectives
of further investigations are to
determine the extent of disease
determine suitable treatment.
Endometrial biopsy using pipelle sampling
with sensitivity of 81-99% and specificity of
98%.
A chest X-ray is essential.
An MRI scan: lymph node metastases and the
presence of occult cervical involvement.
13. 13
Treatment: (premalignant lesions)
Spontaneous regression is possible in
simple hyperplasia without atypia (72%
cases)
Most important determinant for the choice of
treatment is presence of atypia.
Treatment of others either
hormonally/surgically
15. 15
Surgical
The most important mode of treatment
Consists of:
Maylard’s incision (if early) or midline (if advanced)
Thorough intraperitoneal exploration
Peritoneal washing
Extrafascial hysterectomy and bilateral
salphingoophorectomy
Peliv with or without paraaortic lymphadenectomy
Omentectomy- in advanced cases if omentum is
involved.
16. radiotherapy
Only applied adjuvant or if patient is
unstable for surgical treatment
Indications include
Grade 3 tumours
Myometrial invasion >50%
Histology- clear cell ca of uterine papillary
serous carcinoma
Cervical involvment
Lymph node involvment
Lymphovascular space involvment
17. Chemotherapy
Use of adjuvant chemotherapy has been used in recent years
The combination of doxorubicin + cisplatin + paclitaxel
significantly improve overall survival
Because of toxicity considerations, an alternative option may
be the combination of carboplatin and paclitaxel
HRT: continuous combined therapy may be theoretically most
appropriate for post operative patients with persistent
climacteric symptoms (low dose progestin).
19. REFERENCE
1. Endometrial cancer incidence statistic, Srdjan Saso, published 6/7/11
http://www.bmj.com/content/343/bmj.d3954, last viewed on 26/6/13.
2. Incidence of endometrial cancer in Malaysia(2007): http://www.malaysiaoncology.org/article.php?aid=297
3. The New FIGO Staging for Carcinoma of the Vulva, Cervix, Endometrium, and Sarcomas (2009)
http://www.medscape.com/viewarticle/722721
4. Karlsson B, Granberg S, Wikland M et al. (1995) Transvaginal ultrasonography of the endometrium in women
with postmenopausal bleeding – a Nordic multicentre study. Am J Obstet Gynecol, 172, 1488-94.
5. Clark TJ, Barton PM, Coomarasamy A et al. (2006) Investigating postmenopausal bleeding for endometrial cancer:
cost-effectiveness of initial diagnostic strategies. Br J Obstet Gynaecol, 113, 502-10.
6. Creutzberg CL, van Putten WL, Koper PC et al. (2000) Surgery and postoperative radiotherapy versus surgery alone
for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Lancet; 35,
1404-11.
7. North Wales Cancer Guidelines, Endometrial Cancer (April 2008)