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REGUB Path - Uterus (ii) (Leiomyoma (fibroid, benign smooth muscle tumour…
REGUB Path - Uterus (ii)
Carcinoma
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endometrioid adenocarc
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grading based on gland architecture (more aggressive tumours have less glands + are increasingly solid) + nuclear features
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clear cell carc - related to endometrioid, but more mutations - worse prognosis
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a/w PTEN
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normal endometrium: high levels in prolif phase, absent in mid-late secretory phase
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Staging
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if tumour invades outer 1/2 of myometrium, worse prognosis due to access to blood vessels
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Leiomyoma
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round, well-circumscribed, unencapsulated, white, whorled myometrial mass(es)
intramural, submucosal or subserosal
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Leiomyosarcoma
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mitoses, necrosis, atypia, pleomorphism
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recur + met (lung, bone, brain)
single large mass >5cm, usually >10cm, irregular, infiltrating
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Stromal tumours
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stromal nodule: benign, well-circumscribed
stromal sarcoma: infiltrative margin, lymphatic invasion, may recur in approx 11-12 yrs
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